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Dissemination of IMP-1 Metallo-β-Lactamase–Producing Acinetobacter Species in a Brazilian Teaching Hospital

Published online by Cambridge University Press:  21 June 2016

Maria C. B. Tognim ,
Ana C. Gales ,
Andréia P. Penteado ,
Suzane Silbert  and
Hélio S. Sader
Maria C. B. Tognim
Affiliation:
Division of Infectious Diseases, Universidade Federal de São Paulo, São Paulo, Brazil Division of Microbiology, Universidade Estadual de Maringá, Maringá, Paraná, Brazil
Ana C. Gales
Affiliation:
Division of Infectious Diseases, Universidade Federal de São Paulo, São Paulo, Brazil
Andréia P. Penteado
Affiliation:
Division of Infectious Diseases, Universidade Federal de São Paulo, São Paulo, Brazil
Suzane Silbert
Affiliation:
Division of Infectious Diseases, Universidade Federal de São Paulo, São Paulo, Brazil
Hélio S. Sader*
Affiliation:
Division of Infectious Diseases, Universidade Federal de São Paulo, São Paulo, Brazil Division of Microbiology, Universidade Estadual de Maringá, Maringá, Paraná, Brazil
*
JMI Laboratories, 345 Beaver Kreek Centre, Suite A, North Liberty, Iowa 52317 (helio-sader@jmilabs.com)
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Abstract

Objective.

To evaluate the emergence and dissemination of metallo-β-lactamase (MBL)–producing Acinetobacter species.

Design.

All carbapenem-resistant Acinetobacter strains (1 strain per patient) collected during the period 1993–2001 were evaluated.

Setting.

A Brazilian tertiary care teaching hospital (Hospital São Paulo, São Paulo).

Methods.

Seventy-three strains of carbapenem-resistant Acinetobacter species were recovered from the organism bank of the hospital. All isolates were tested for antimicrobial susceptibility by broth microdilution methods, and the production of MBL was initially assessed by phenotypic tests (MBL Etest strip and a disk approximation test). The MBL enzymes were identified by polymerase chain reaction using primers for bla IMP’, bla VIM’, and bla SPM’ followed by gene sequencing. Genetic similarity among the carbapenem-resistant strains was evaluated by automated ribotyping.

Results.

Only colistin and ampicillin-sulbactam showed reasonable in vitro activity against carbapenem-resistant isolates (97% and 74% of isolates susceptible, respectively). More than half of the isolates (55%) had a positive MBL phenotypic test result and a positive polymerase chain reaction result for bla IMP_1 The proportion of IMP-1–producing Acinetobacter isolates among carbapenem-resistant strains increased from 0% in the 1993-1997 period to 29% in 1998 and 100% in the 1999-2001 period. No carbapenem-resistant Acinetobacter isolates that harbored bla VIM or bla SPM were detected. Molecular typing results revealed 20 ribogroups among carbapenem-resistant isolates. During the study period of 1994-2001, we identified 2 major ribogroups, 52-1 (MBL-negative and MBL-positive strains) and 60-7 (MBL-positive strains), that had a coefficient of similarity of 0.85 or higher.

Conclusions.

Our results indicate that IMP-1–producing strains of Acinetobacter emerged in our institution in 1998. Since then, production of this MBL was detected not only in the major ribogroups of carbapenem-resistant Acinetobacter species but also among isolates that belonged to 17 distinct ribogroups, indicating that this important mechanism of antimicrobial resistance was disseminated among distinct clones.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 7 , July 2006 , pp. 742 - 747
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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