title: First countrywide survey of acquired metallo-beta-lactamases in gram-negative pathogens in Italy.
abstract: Metallo-beta-lactamases (MBLs) can confer resistance to most beta-lactams, including carbapenems. Their emergence in gram-negative pathogens is a matter of major concern. Italy was the first European country to report the presence of acquired MBLs in gram-negative pathogens and is one of the countries where MBL producers have been detected repeatedly. Here, we present the results of the first Italian nationwide survey of acquired MBLs in gram-negative pathogens. Of 14,812 consecutive nonreplicate clinical isolates (12,245 Enterobacteriaceae isolates and 2,567 gram-negative nonfermenters) screened for reduced carbapenem susceptibility during a 4-month period (September to December 2004), 30 isolates (28 Pseudomonas aeruginosa isolates, 1 Pseudomonas putida isolate, and 1 Enterobacter cloacae isolate) carried acquired MBL determinants. MBL producers were detected in 10 of 12 cities, with a predominance of VIM-type enzymes over IMP-type enzymes (4:1). Although having an overall low prevalence (1.3%) and significant geographical differences, MBL-producing P. aeruginosa strains appeared to be widespread in Italy, with a notable diversity of clones, enzymes, and integrons carrying MBL gene cassettes.
authors.affiliation: Dipartimento di Biologia Molecolare, Sezione di Microbiologia, Università di Siena, Policlinico Santa Maria alle Scotte, I-53100 Siena, Italy. rossolini@unisi.it
authors.forename: Gian Maria
authors.initials: GM
authors.lastname: Rossolini
authors.forename: Francesco
authors.initials: F
authors.lastname: Luzzaro
authors.forename: Roberta
authors.initials: R
authors.lastname: Migliavacca
authors.forename: Claudia
authors.initials: C
authors.lastname: Mugnaioli
authors.forename: Beatrice
authors.initials: B
authors.lastname: Pini
authors.forename: Filomena
authors.initials: F
authors.lastname: De Luca
authors.forename: Mariagrazia
authors.initials: M
authors.lastname: Perilli
authors.forename: Simona
authors.initials: S
authors.lastname: Pollini
authors.forename: Melissa
authors.initials: M
authors.lastname: Spalla
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Amicosante
authors.forename: Antonio
authors.initials: A
authors.lastname: Toniolo
authors.forename: Laura
authors.initials: L
authors.lastname: Pagani
mesh_terms: D001483:Base Sequence; D017931:DNA Primers / Q000235:genetics; D004269:DNA, Bacterial / Q000235:genetics; D003625:Data Collection; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D005798:Genes, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics / Q000472:pathogenicity; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D032023:Integrons; D007558:Italy / Q000453:epidemiology; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D018440:beta-Lactam Resistance / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D017931:DNA Primers; D004269:DNA, Bacterial; D001618:beta-Lactamases