title: Plasmid-mediated carbapenem-hydrolyzing enzyme KPC-2 and ArmA 16S rRNA methylase conferring high-level aminoglycoside resistance in carbapenem-resistant Enterobacter cloacae in China.
abstract: The emergence and spread of carbapenem-resistant Enterobacteriaceae in the world are a major concern. We investigated 5 isolates of Enterobacter cloacae that were resistant to all clinically available antimicrobial agents, except polymyxin B. The MICs of imipenem and aminoglycosides were >32 and >256 mg/L, respectively. All of the isolates produced 5 extended-spectrum beta-lactamase (ESBLs) with pIs of 5.4 (TEM-1), 6.7 (KPC-2), 8.2 (SHV-12), 8.4 (CTX-M-14), and ArmA 16S rRNA methylase. bla(KPC-2) was located on a large nonconjugative plasmid, whereas armA was located on another conjugative plasmid. Although carbapenem-resistant Enterobacteriaceae remains rare, the emergence of this group of organism merits monitoring.
authors.affiliation: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China.
authors.forename: Qiong
authors.initials: Q
authors.lastname: Wu
authors.forename: Qingzhong
authors.initials: Q
authors.lastname: Liu
authors.forename: Lizhong
authors.initials: L
authors.lastname: Han
authors.forename: Jingyong
authors.initials: J
authors.lastname: Sun
authors.forename: Yuxing
authors.initials: Y
authors.lastname: Ni
mesh_terms: D000617:Aminoglycosides / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism; D015780:Carbapenems / Q000494:pharmacology*; D024901:Drug Resistance, Multiple, Bacterial; D016972:Enterobacter cloacae / Q000187:drug effects* / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000382:microbiology; D006801:Humans; D008780:Methyltransferases / Q000235:genetics* / Q000378:metabolism; D008826:Microbial Sensitivity Tests; D010957:Plasmids / Q000235:genetics*; D012335:RNA, Ribosomal / Q000235:genetics / Q000378:metabolism; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism
chemical_list: D000617:Aminoglycosides; D001426:Bacterial Proteins; D015780:Carbapenems; D012335:RNA, Ribosomal; D008780:Methyltransferases; C491478:beta-lactamase KPC-2; D001618:beta-Lactamases