title: Molecular epidemiology of ESbetaL producing P. mirabilis strains from a long-term care and rehabilitation facility in Italy.
abstract: We report the detection of multidrug resistant ESbetaL producing Proteus mirabilis isolates from a long-term care and rehabilitation facility (LTCRF) in Northern Italy. 53% of the collected P. mirabilis strains were ESbetaL producers. PCR and sequencing techniques confirmed the presence of the bla(TEM-92) and bla(CMY-16) resistance genes in 23/26 (88.5%) and 3/26 (11.5%) of the ESbetaL producers respectively. PFGE showed that the TEM-92 beta-lactamase producing isolates were not clonally related, indicating the presence of at least four different clonal lineages (A, B, C, D), whereas all the CMY-16 enzyme producers belonged in the same lineage. The bla(TEM-92) and bla(CYY-16) determinants were distributed in seven different wards, but in three of them they coexisted. Our results show that the most patients are co-colonized by ESbetaLs producing P. mirabilis strains at the time of admission to an LTCRF. An effective strategy to curtail the spread of ESbetaLs mediated resistance in LTCRFs could be to activate sourveillance programs to monitor routinely the entry of resistant bacteria.
authors.affiliation: Dipartimento di Scienze Morfologiche Eidologiche e Cliniche, sezione di Microbiologia, Università di Pavia, Italia.
authors.forename: Roberta
authors.initials: R
authors.lastname: Migliavacca
authors.forename: Anna
authors.initials: A
authors.lastname: Migliavacca
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Nucleo
authors.forename: Anna
authors.initials: A
authors.lastname: Ciaponi
authors.forename: Melissa
authors.initials: M
authors.lastname: Spalla
authors.forename: Concetta
authors.initials: C
authors.lastname: De Luca
authors.forename: Laura
authors.initials: L
authors.lastname: Pagani
mesh_terms: D024881:Drug Resistance, Bacterial / Q000235:genetics; D005798:Genes, Bacterial / Q000235:genetics; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008134:Long-Term Care; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D011512:Proteus Infections / Q000453:epidemiology*; D011513:Proteus mirabilis / Q000201:enzymology / Q000235:genetics*; D012047:Rehabilitation Centers; D001618:beta-Lactamases / Q000378:metabolism