title: Examination of cfiA-mediated carbapenem resistance in Bacteroides fragilis strains from a European antibiotic susceptibility survey.
abstract: Of 1284 Bacteroides strains collected in Europe in 2000 for antibiotic susceptibility surveillance, 65 isolates displayed imipenem minimum inhibitory concentrations (MICs) > or =1 mg/L and were chosen for a thorough analysis of their resistance mechanism. Twenty-five of the isolates were positive for the cfiA carbapenem resistance gene. The resistance rates were 0.8% and 1.3% for imipenem and meropenem, respectively. In six of the strains, insertion sequence (IS) elements (IS613, IS614B, IS1186 and IS1187) activated the cfiA gene. However, other strains displayed at least elevated carbapenem MICs or were carbapenem resistant and produced measurable carbapenemase activities but did not harbour IS elements in the region upstream of the cfiA gene. The major determinant of carbapenem resistance in Bacteroides fragilis is production of CfiA metallo-beta-lactamase via activation of the cfiA gene by IS elements (higher level resistance) or by activation of its putative own promoter.
authors.affiliation: Institute of Clinical Microbiology, Faculty of General Medicine, University of Szeged, H-6725 Szeged, Somogyi Béla tér 1, Hungary. soki@mlab.szote.u-szeged.hu
authors.forename: J
authors.initials: J
authors.lastname: Sóki
authors.forename: R
authors.initials: R
authors.lastname: Edwards
authors.forename: M
authors.initials: M
authors.lastname: Hedberg
authors.forename: H
authors.initials: H
authors.lastname: Fang
authors.forename: E
authors.initials: E
authors.lastname: Nagy
authors.forename: C E
authors.initials: CE
authors.lastname: Nord
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics* / Q000378:metabolism; D001442:Bacteroides Infections / Q000453:epidemiology* / Q000382:microbiology; D001441:Bacteroides fragilis / Q000187:drug effects* / Q000235:genetics; D001483:Base Sequence; D015780:Carbapenems / Q000494:pharmacology*; D004251:DNA Transposable Elements; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D005060:Europe / Q000453:epidemiology; D006801:Humans; D015378:Imipenem; D000077731:Meropenem; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D011159:Population Surveillance; D013845:Thienamycins; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D004251:DNA Transposable Elements; D013845:Thienamycins; D015378:Imipenem; D001618:beta-Lactamases; C063912:carbapenemase; D000077731:Meropenem