title: High diversity of beta-lactamases in the General Hospital Vienna verified by whole genome sequencing and statistical analysis.
abstract: The detailed analysis of antibiotic resistance mechanisms is essential for understanding the underlying evolutionary processes, the implementation of appropriate intervention strategies and to guarantee efficient treatment options. In the present study, 110 β-lactam-resistant, clinical isolates of Enterobacteriaceae sampled in 2011 in one of Europe's largest hospitals, the General Hospital Vienna, were screened for the presence of 31 β-lactamase genes. Twenty of those isolates were selected for whole genome sequencing (WGS). In addition, the number of β-lactamase genes was estimated using biostatistical models. The carbapenemase genes blaKPC-2, blaKPC-3, and blaVIM-4 were identified in carbapenem-resistant and intermediate susceptible isolates, blaOXA-72 in an extended-spectrum β-lactamase (ESBL)-positive one. Furthermore, the observed high prevalence of the acquired blaDHA-1 and blaCMY AmpC β-lactamase genes (70%) in phenotypically AmpC-positive isolates is alarming due to their capability to become carbapenem-resistant upon changes in membrane permeability. The statistical analyses revealed that approximately 55% of all β-lactamase genes present in the General Hospital Vienna were detected by this study. In summary, this work gives a very detailed picture on the disseminated β-lactamases and other resistance genes in one of Europe's largest hospitals.
authors.affiliation: AIT Austrian Institute of Technology, Molecular Diagnostics, Muthgasse 11/2, 1190 Vienna, Austria. Electronic address: ivan.barisic@ait.ac.at.
authors.forename: Ivan
authors.initials: I
authors.lastname: Barišić
authors.affiliation: Medical University of Vienna, Department of Laboratory Medicine, Division of Clinical Microbiology, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address: dieter.mitteregger@meduniwien.ac.at.
authors.forename: Dieter
authors.initials: D
authors.lastname: Mitteregger
authors.affiliation: Medical University of Vienna, Department of Laboratory Medicine, Division of Clinical Microbiology, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address: alexander.hirschl@meduniwien.ac.at.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Hirschl
authors.affiliation: AIT Austrian Institute of Technology, Molecular Diagnostics, Muthgasse 11/2, 1190 Vienna, Austria. Electronic address: christa.noehammer@ait.ac.at.
authors.forename: Christa
authors.initials: C
authors.lastname: Noehammer
authors.affiliation: AIT Austrian Institute of Technology, Molecular Diagnostics, Muthgasse 11/2, 1190 Vienna, Austria. Electronic address: herbert.wiesinger-mayr@ait.ac.at.
authors.forename: Herbert
authors.initials: H
authors.lastname: Wiesinger-Mayr
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001317:Austria; D015780:Carbapenems / Q000494:pharmacology; D003428:Cross Infection; D004755:Enterobacteriaceae / Q000187:drug effects / Q000235:genetics*; D004756:Enterobacteriaceae Infections / Q000382:microbiology*; D005787:Gene Frequency; D014644:Genetic Variation; D016680:Genome, Bacterial; D006769:Hospitals, General; D006801:Humans; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D017422:Sequence Analysis, DNA; D018440:beta-Lactam Resistance / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D001618:beta-Lactamases
keywords: AmpC; Carbapenemase; Chao1; ESBL; Rarefaction curve; Whole genome sequencing