title: Providencia stuartii Isolates from Greece: Co-Carriage of Cephalosporin (blaSHV-5, blaVEB-1), Carbapenem (blaVIM-1), and Aminoglycoside (rmtB) Resistance Determinants by a Multidrug-Resistant Outbreak Clone.
abstract: Providencia stuartii has emerged as an important nosocomial pathogen. We describe an outbreak due to a multidrug-resistant strain over a 4-month period in a critical care unit in Athens. Molecular typing revealed each of the isolates to be clonally related with coresistance to cephalosporins, carbapenems, aminoglycosides, and quinolones. Each isolate contained a 220-kb multi-replicon (IncA/C and IncR) conjugative plasmid encoding TEM-1, SHV-5, VEB-1, and VIM-1 β-lactamases and the 16S rDNA methylase RmtB. Antimicrobial therapy was unsuccessful in 3 of 6 cases, and resistance was readily transmissible to susceptible strains of Escherichia coli by transformation and conjugation. This highlights the clinical importance of P. stuartii and its ability to disseminate critical resistance determinants to other bacterial pathogens.
authors.affiliation: 1 Antimicrobial Research Group, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University London , London, United Kingdom .
authors.forename: Olga
authors.initials: O
authors.lastname: Oikonomou
authors.affiliation: 2 Department of Bacteriology and TSEs, Central Veterinary Institute, Wageningen University , Lelystad, the Netherlands .
authors.forename: Apostolos
authors.initials: A
authors.lastname: Liakopoulos
authors.affiliation: 1 Antimicrobial Research Group, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University London , London, United Kingdom .
authors.forename: Lynette M
authors.initials: LM
authors.lastname: Phee
authors.affiliation: 1 Antimicrobial Research Group, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University London , London, United Kingdom .
authors.forename: Jonathan
authors.initials: J
authors.lastname: Betts
authors.affiliation: 2 Department of Bacteriology and TSEs, Central Veterinary Institute, Wageningen University , Lelystad, the Netherlands .
authors.forename: Dik
authors.initials: D
authors.lastname: Mevius
authors.affiliation: 1 Antimicrobial Research Group, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University London , London, United Kingdom .
authors.forename: David W
authors.initials: DW
authors.lastname: Wareham
mesh_terms: D000328:Adult; D000368:Aged; D000617:Aminoglycosides / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics*; D015780:Carbapenems / Q000494:pharmacology; D002511:Cephalosporins / Q000494:pharmacology; D002999:Clone Cells; D003227:Conjugation, Genetic; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D005260:Female; D015870:Gene Expression; D022761:Gene Transfer, Horizontal; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D008780:Methyltransferases / Q000235:genetics; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010957:Plasmids / Q000737:chemistry / Q000378:metabolism; D011532:Providencia / Q000187:drug effects / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D015363:Quinolones / Q000494:pharmacology; D012093:Replicon; D016019:Survival Analysis; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D002511:Cephalosporins; D015363:Quinolones; D008780:Methyltransferases; D001618:beta-Lactamases