Detection of the new metallo-beta-lactamase VIM-19 along with KPC-2, CMY-2 and CTX-M-15 in Klebsiella pneumoniae.
OBJECTIVE
To report the identification of the metallo-beta-lactamase (MBL) variant VIM-19 in a Klebsiella pneumoniae clinical strain co-producing KPC-2 carbapenemase, CMY-2 cephalosporinase and CTX-M-15 extended-spectrum beta-lactamase.


METHODS
MICs were determined by agar dilution. Phenotypic tests were performed to detect carbapenemase production. PCR and nucleotide sequencing were used for the identification of bla gene types and mapping of the integron carrying the MBL gene. The location of the MBL and KPC alleles was investigated by mating experiments, plasmid analysis and PCR assays.


RESULTS
Imipenem, meropenem and ertapenem MICs for the study strain were 32, 16 and 64 mg/L, respectively. The strain carried bla(TEM-1), bla(CMY-2), bla(KPC-2) and bla(CTX-M-15) genes along with the gene bla(VIM-19), which was located in a class 1 integron as the first gene cassette, followed by aacA6, dfrA1 and aadA1 cassettes. Mating experiments, plasmid analysis and PCR assays revealed that bla(VIM-19) and bla(CMY-2) were carried on an approximately 150 kb self-transferable plasmid, while bla(KPC-2) and bla(TEM-1) were on an approximately 70 kb self-transferable plasmid; bla(CTX-M-15) was non-transferable.


CONCLUSIONS
The detection of the new MBL, VIM-19, which has enhanced carbapenemase activity, along with KPC-2, CMY-2 and CTX-M-15 is of concern. Further spread of the respective strains or plasmids may have serious consequences for antimicrobial chemotherapy.
Pournaras
Spyros
S
Department of Microbiology, Medical School, University of Thessaly, Larissa, Greece. pournaras@med.uth.gr
Poulou
Aggeliki
A
Voulgari
Evangelia
E
Vrioni
Georgia
G
Kristo
Ioulia
I
Tsakris
Athanassios
A
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D003227:Conjugation, Genetic; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D005260:Female; D006801:Humans; D032023:Integrons; D007710:Klebsiella Infections / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000201:enzymology* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D008969:Molecular Sequence Data; D010957:Plasmids / Q000032:analysis; D016133:Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics*
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D001618:beta-Lactamases