title: Detection of the carbapenemase GIM-1 in Enterobacter cloacae in Germany.
abstract: OBJECTIVE
  To characterize the mechanisms involved in reduced susceptibility to carbapenems in two Enterobacter cloacae clinical isolates.
  
  
  METHODS
  Two E. cloacae isolates recovered from different regions in Germany and showing reduced susceptibility to carbapenems were analysed. Susceptibility testing, conjugation, transformation assays, plasmid analysis, sequencing and molecular typing using rep-PCR were performed.
  
  
  RESULTS
  The two clinical isolates carried the bla(GIM-1) gene and showed resistance to ertapenem, with variable MIC values of imipenem and meropenem. The isolates were clonally unrelated. The bla(GIM-1) gene was located on self-transferable and non-typeable plasmids. Both isolates harboured distinct plasmids and integron structures containing the bla(GIM-1) gene cassette. Interestingly, one of the two plasmids was able to replicate in Pseudomonas aeruginosa, demonstrating its broad host range.
  
  
  CONCLUSIONS
  This is the first identification in E. cloacae of the bla(GIM-1) gene, which is responsible for reduced susceptibility to carbapenems. We showed that this gene, previously identified in P. aeruginosa, was located in a different genetic background in E. cloacae. The bla(GIM-1) gene might spread quite efficiently in Enterobacteriaceae and P. aeruginosa, as it is difficult to detect and in addition is located on conjugative plasmids.
authors.affiliation: Service de Bactériologie-Virologie, INSERM U914 "Emerging Resistance to Antibiotics", Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris,  Faculté de Médecine et Université Paris-Sud, Kremlin-Bicêtre,  France.
authors.forename: Axel
authors.initials: A
authors.lastname: Hamprecht
authors.forename: Laurent
authors.initials: L
authors.lastname: Poirel
authors.forename: Stephan
authors.initials: S
authors.lastname: Göttig
authors.forename: Harald
authors.initials: H
authors.lastname: Seifert
authors.forename: Martin
authors.initials: M
authors.lastname: Kaase
authors.forename: Patrice
authors.initials: P
authors.lastname: Nordmann
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics*; D015780:Carbapenems / Q000494:pharmacology*; D003227:Conjugation, Genetic; D016972:Enterobacter cloacae / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000382:microbiology; D005858:Germany; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D058889:Molecular Typing; D010957:Plasmids / Q000032:analysis; D016133:Polymerase Chain Reaction; D011550:Pseudomonas aeruginosa / Q000235:genetics; D017422:Sequence Analysis, DNA; D014170:Transformation, Genetic; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D001618:beta-Lactamases; C063912:carbapenemase