title: Nosocomial spread of Pseudomonas aeruginosa producing the metallo-beta-lactamase VIM-2 in a Spanish hospital: clinical and epidemiological implications.
abstract: Thirty-four isolates of pan-resistant Pseudomonas aeruginosa producing VIM-2 metallo-beta-lactamase (MBL) were detected at a university hospital in Spain (July 2004-September 2006). Eleven (32%) patients had clinically significant infections, and three (27%) of these patients died. A single clone of MBL-producing P. aeruginosa was identified by pulsed-field gel electrophoresis. A cluster of isolates associated with the vascular surgery ward involved ten patients and appeared as a series of low-grade, sustained and misdiagnosed endemic infections in the hospital. The identification of MBL-positive P. aeruginosa should be considered mandatory in the surveillance of pan-resistant P. aeruginosa and requires a high index of suspicion in the context of endemic infections with a low attack rate.
authors.affiliation: Infectious Diseases Service, Hospital Universitari de Bellvitge, Barcelona, Spain. cpena@csub.scs.es
authors.forename: C
authors.initials: C
authors.lastname: Peña
authors.forename: C
authors.initials: C
authors.lastname: Suarez
authors.forename: F
authors.initials: F
authors.lastname: Tubau
authors.forename: O
authors.initials: O
authors.lastname: Gutierrez
authors.forename: A
authors.initials: A
authors.lastname: Domínguez
authors.forename: A
authors.initials: A
authors.lastname: Oliver
authors.forename: M
authors.initials: M
authors.lastname: Pujol
authors.forename: F
authors.initials: F
authors.lastname: Gudiol
authors.forename: J
authors.initials: J
authors.lastname: Ariza
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D019353:Endemic Diseases; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011159:Population Surveillance; D011552:Pseudomonas Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics / Q000472:pathogenicity; D013030:Spain / Q000453:epidemiology; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; C425108:beta-lactamase bla(vim-2); D001618:beta-Lactamases