TABLE 2.
Epidemiological data, MBL determinants, clonal lineages, and resistance phenotypes for the MBL-producing isolates
| Isolatea | Specimen | Wardh | Enzyme | Clone | Integronb | MICc (μg/ml) of:
|
|||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PIP | TZP | CAZ | FEP | ATM | IMP | MEM | COL | AMK | GEN | CIP | LEV | ||||||
| TO-16X-51 | Urine | ICU | VIM-1 | NAd | NA | >128 | >128 | >128 | 128 | 8 | 4 | 2 | 0.25 | 24 | 2 | >32 | >32 |
| RM-11X-11 | Urine | ICU | VIM-1 | NA | NA | >128 | >128 | >128 | >128 | 8 | >32 | >32 | 0.25 | 1 | 4 | 0.06 | 0.25 |
| FG-17X-14 | Sputum | ICU | VIM-1 | A1 | In70e | >128 | >128 | >128 | >128 | 6 | >32 | >32 | 1 | 8 | >128 | >32 | >32 |
| NA-14X-21 | Urine | ICU | VIM-1 | A2 | In70 | >128 | >128 | >128 | >128 | 8 | >32 | >32 | 2 | 24 | >128 | >32 | >32 |
| NA-14X-26 | Urine | ICU | VIM-1 | A2 | NA | >128 | >128 | >128 | >128 | 8 | >32 | >32 | 2 | 32 | >128 | >32 | >32 |
| NA-14X-32 | Urine | ICU | VIM-1 | A2 | NA | >128 | >128 | >128 | >128 | 6 | >32 | >32 | 2 | 24 | >128 | >32 | >32 |
| NA-14X-34 | Urine | ICU | VIM-1 | A3 | In70 | >128 | >128 | >128 | >128 | 6 | >32 | >32 | 2 | 24 | >128 | >32 | >32 |
| FG-17X-08 | Sputum | ICU | VIM-1 | A3 | NA | >128 | >128 | >128 | >128 | 64 | >32 | >32 | 0.5 | 16 | >128 | >32 | >32 |
| VA-06X-69 | Urine | Nephrology | VIM-1 | D | In110e | >128 | >128 | >128 | >128 | 4 | >32 | >32 | 1 | 8 | >128 | >32 | >32 |
| VA-06X-63 | Blood | Nephrology | VIM-1 | D1 | NA | >128 | >128 | >128 | >128 | 4 | >32 | >32 | 1 | 8 | >128 | >32 | >32 |
| VA-06X-16 | Wound specimen | Geriatrics | VIM-1 | D2 | In110 | >128 | >128 | >128 | >128 | 4 | >32 | >32 | 1 | 8 | >128 | >32 | >32 |
| VA-06X-17 | Wound specimen | Pneumology | VIM-1 | D2 | In110 | >128 | >128 | >128 | >128 | 6 | >32 | >32 | 1 | 8 | >128 | >32 | >32 |
| VA-06X-65 | Sputum | Pneumology | VIM-1 | D3 | In110 | >128 | >128 | >128 | >128 | 0.25 | >32 | >32 | 0.5 | 8 | >128 | >32 | >32 |
| VA-06X-47 | Urine | Nephrology | VIM-1 | D4 | In110 | >128 | >128 | >128 | >128 | 4 | >32 | >32 | 1 | 8 | >128 | >32 | >32 |
| VA-06X-29 | Pus | Otology | VIM-1 | E | In80e | >128 | >128 | >128 | >128 | 8 | >32 | >32 | 2 | >128 | >128 | >32 | >32 |
| RM-11X-09 | Wound specimen | ICU | VIM-1 | F | In75f | >128 | >128 | >128 | >128 | 16 | >32 | >32 | 1 | 8 | >128 | >32 | >32 |
| NA-14X-13 | Blood | ICU | VIM-1 | G | In105e | >128 | >128 | >128 | >128 | 8 | >32 | >32 | 2 | 128 | >128 | >32 | >32 |
| SS-09X-45 | Urine | Nephrology | VIM-2 | B1 | NAg | >128 | >128 | >128 | >128 | 6 | >32 | >32 | 2 | 128 | >128 | >32 | >32 |
| VA-06X-20 | Urine | Orthopedics | VIM-2 | B2 | NA | 64 | 48 | 64 | 64 | 8 | >32 | >32 | 1 | >128 | 8 | >32 | >32 |
| VA-06X-28 | Blood | Geriatrics | VIM-2 | B2 | NA | 64 | 48 | 64 | 64 | 8 | >32 | >32 | 1 | >128 | 8 | >32 | >32 |
| VA-06X-38 | Wound specimen | Geriatrics | VIM-2 | B2 | In59e | 32 | 32 | 48 | 48 | 4 | >32 | >32 | 1 | >128 | 8 | >32 | >32 |
| CR-04X-14 | Blood | ICU | VIM-2 | B3 | NA | >128 | >128 | 64 | 64 | 8 | >32 | >32 | 2 | >128 | 8 | >32 | >32 |
| PV-05X-02 | Wound specimen | Medicine | VIM-2 | B3 | In59 | 48 | 32 | 32 | 32 | 8 | >32 | 8 | 1 | >128 | 8 | >32 | >32 |
| PV-05X-07 | Vascular catheter specimen | Pneumology | VIM-2 | B3 | NA | 48 | 32 | 32 | 48 | 8 | >32 | 8 | 1 | >128 | 8 | >32 | >32 |
| AV-13X-28 | Urine | ICU | IMP-13 | C1 | In88f | 24 | 16 | >128 | >128 | 8 | 16 | 8 | 2 | 8 | >128 | >32 | >32 |
| NA-14X-02 | Urine | Urology | IMP-13 | C2 | In89f | 24 | 16 | >128 | >128 | 16 | >32 | >32 | 0.5 | 16 | >128 | >32 | >32 |
| NA-14X-10 | Blood | ICU | IMP-13 | C2 | NA | 16 | 16 | >128 | >128 | 16 | >32 | >32 | 0.5 | 16 | >128 | >32 | >32 |
| NA-14X-11 | Urine | Urology | IMP-13 | C2 | NA | 16 | 16 | >128 | >128 | 16 | >32 | >32 | 0.5 | 16 | >128 | >32 | >32 |
| NA-14X-12 | Urine | Urology | IMP-13 | C2 | NA | 16 | 16 | >128 | >128 | 16 | >32 | >32 | 0.5 | 16 | >128 | >32 | >32 |
| PG-12X-03 | Sputum | ICU | IMP-13 | C3 | InPSGe | 16 | 16 | >128 | >128 | 16 | >32 | >32 | 0.5 | >128 | >128 | >32 | >32 |
The first two letters of the name indicate the city of origin (Fig. 1), as follows: TO, Turin; RM, Rome; FG, Foggia; NA, Naples; VA, Varese; SS, Sassari; CR, Cremona; PV, Pavia; AV, Avellino; and PG, Perugia. The first two isolates listed, TO-16X-51 and RM-11X-11, were E. cloacae and P. putida, respectively; all other isolates listed were P. aeruginosa.
The structures of the variable regions of class 1 integrons carrying MBL gene cassettes in P. aeruginosa isolates representative of different clonal lineages and variants thereof were determined.
Abbreviations for antimicrobial agents: PIP, piperacillin; TZP, piperacillin-tazobactam; CAZ, ceftazidime; FEP, cefepime; ATM, aztreonam; IPM, imipenem; MEM, meropenem; COL, colistin; AMK, amikacin; GEN, gentamicin; CIP, ciprofloxacin; and LEV, levofloxacin.
NA, not applicable.
New integron detected in this work.
Amplification of the blaVIM-2-containing integron was unsuccessful with this isolate.
Ward in which the patient providing the sample was hospitalized. ICU, intensive care unit.