title: [Increase of metallo-beta-lactamase producing bacteria positive cases including Klebsiella pneumoniae in a Japanese university hospital].
abstract: The clinical characteristics of the metallo-beta-lactamase (MBL) producing bacteria were investigated in a Japanese university hospital with 661 beds. In total, 34 cases (38 strains) were isolated from March 2006 to October 2007. No MBL-producing strain was detected until then. We screened for MBL using Arakawa's method because it detects MBL-producing bacteria more sensitively than conventional methods. Anti-biotic resistant genes were analyzed in 24 MBL producing bacteria positive cases detected from September 2007 to August 2008. Either bla(IMP-1) or bla(IMP-11) was detected in all cases. Age distribution of the MBL producing bacteria positive cases had two peaks, infant age (under five-years-old) and senior age (over seventies). All cases have underlying diseases, such as diabetes mellitus, malignant tumor, granulocytopenia, and/or using steroids. Twenty-one strains were detected from postoperative cases. MBL carrier rate in total clinically isolated Klebsiella pneumoniae strains was 2.6%. As far as we know, this number is the highest among reports in Japanese hospitals. The clinical manifestation of K. pneumoniae as pathogen was identified in only two cases (5%). In 24 cases (82%), MBL-producing bacteria were identified as bystanders. Though infection cases by MBL-producing bacteria especially by K. pneumoniae have not been frequently observed, we should carefully watch their numbers because the bacteria transfer resistant genes among their flora.
authors.affiliation: Department of Laboratory Medicine and Central Clinical Laboratory, Showa University Northern Yokohama Hospital, Yokohama 224-8503, Japan.
authors.forename: Takamichi
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kimura
authors.forename: Emiko
authors.initials: E
authors.lastname: Nakama
authors.forename: Gelin
authors.initials: G
authors.lastname: Chen
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Fukuchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001419:Bacteria / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial / Q000235:genetics; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification*; D008875:Middle Aged; D009894:Opportunistic Infections / Q000453:epidemiology* / Q000382:microbiology*; D055815:Young Adult; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D000900:Anti-Bacterial Agents; C409201:beta-lactamase IMP-1; D001618:beta-Lactamases