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Emergence and dissemination of metallo-b-lactamases producing strains in Europe: report from the SENTRY Antimicrobial Surveillance Program

Abstract number: 1733_74

Deshpande L., Sader H., Fritsche T., Jones R.

Objective: To evaluate the emergence and dissemination of metallo-b-lactamase (MBL) producing strains in European medical centres participating in the SENTRY Program.

Methods: Beginning in 2000 all Gram-negative bacilli submitted to SENTRY with decreased susceptibility to imipenem (IPM), meropenem and ceftazidime were routinely screened for production of MBL by disk approximation tests and/or MBL Etest (AB BIODISK) strips. Isolates with screen-positive results were evaluated by PCR using generic primers for IMP, VIM, SPM and GIM enzyme types. MBL gene sequencing and molecular typing (ribotyping, PFGE) were additionally performed to characterise MBL and to evaluate clonality.

Organism (no.)MBL (no. of strains)Countries (no. of strains)Detection year
P. aeruginosa (46)VIM-1 (32)Germany (4)/Greece (7)/Italy (21)2001–2004
VIM-2 (2)France (1)/Poland (1)2001 and 2003  
IMP-13 (6)Italy (6)2002–2002  
GIM-1 (6)Germany (6)2002  
K. pneumoniae (33)VIM-1 (33)Germany (1)/Greece (16)/Italy (12)/Spain (3)/Turkey (1)2005–2006
E. cloacae (19)VIM-1 (7)Germany (3)/Italy (2)/Spain (2)2004–2006
IMP-1 (12)Turkey (12)2003–2004  
E. aerogenes (2)VIM-1 (2)Greece (2)2005
Acinetobacter spp. (2)IMP-2 (1)Italy (1)2003
VIM-1 (1)Greece (1)2003  
C. koseri (1)VIM-1 (1)Italy (1)2005
K. ozaenae (1)VIM-1 (1)Italy (1)2005
P. mirabilis (1)VIM-1 (1)Greece (1)2005

Results: Since 2000, 4,935 P. aeruginosa (PSA), 1,460 Acinetobacter spp. (ASP) and 22,950 Enterobacteriaceae (ENT) have been collected from European centres and tested for susceptibility (S) by reference broth microdilution methods (CLSI, 2006). S rates to IMP remained stable among PSA (75.5% in 2000 and 76.1% in 2006), but varied from 78.5% in 2000 to 51.9% in 2006 among ASP. IMP remained very active against ENT (99.8% S in 2006), but the occurrence of strains with MIC ≥2 mg/L increased from 0.4% in 2000 to 1.5% in 2006. A total of 105 MBL-producing strains were identified and characterised since 2000. The most common MBL-producing species were PSA with 46 strains from 5 countries and producing 4 different MBLs; followed by K. pneumoniae (KPN; 33 VIM-1-producing strains from 5 countries) and E. cloacae (ECL; 19 strains, VIM-1 and IMP-1-producers from 4 countries). MBL-producing strains were usually resistant to most antimicrobials tested. Polymyxin B was very active against PSA (100% S) and KPN (94% S); while tigecycline was highly active (100% S) against ASP, KPN and ECL. Molecular typing results indicated clonal dissemination of PSA producing VIM-1 in Germany, Greece and Italy, IMP-13 in Italy and GIM-1 in Germany; KPN producing VIM-1 in Greece, Italy and Spain; and IMP-1-producing ECL in Turkey. In addition, clonal diversity was observed among IMP-13-producing PSA from Rome, Italy; VIM-producing KPN from Athens, Greece and ECL from Leipzig, Germany and Madrid, Spain; and IMP-1 producing ECL from Istanbul, Turkey.

Conclusions: The emergence and dissemination of MBL-producing strains was documented in several European countries and it is of great concern since these enzymes were usually codified by genes located on integrons with great mobility.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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