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Antimicrobial Agents and Chemotherapy, March 2006, p. 880-886, Vol. 50, No. 3
0066-4804/06/$08.00+0     doi:10.1128/AAC.50.3.880-886.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Molecular Epidemiology of Acquired-Metallo-ß-Lactamase-Producing Bacteria in Poland

Janusz Fiett,¹ Anna Baraniak,¹ Agnieszka Mrówka,¹ Magorzata Fleischer,² Zuzanna Drulis-Kawa,³ ukasz Naumiuk,⁴ Alfred Samet,⁴ Waleria Hryniewicz,¹ and Marek Gniadkowski^1*

National Institute of Public Health, 00-725 Warsaw, Poland,¹ Department of Microbiology, Medical University in Wrocaw, 50-368 Wrocaw, Poland,² Institute of Microbiology, Wrocaw University, 51-148 Wrocaw, Poland,³ Department of Clinical Microbiology, Public Hospital No. 1, 80-211 Gdask, Poland⁴

Received 29 September 2005/ Returned for modification 5 November 2005/ Accepted 3 January 2006

We have analyzed 40 metallo-ß-lactamase (MBL)-producing isolates of Pseudomonas aeruginosa (n = 38), Pseudomonas putida (n = 1), and Acinetobacter genospecies 3 (n = 1) from 17 hospitals in 12 cities in Poland that were identified in 2000 to 2004. Pulsed field gel electrophoresis typing classified the P. aeruginosa isolates into eight types, with two types differentiated further into subtypes. Each of the types was specific either to a given center or to several hospitals of the same or neighboring geographic area. Almost all of the organisms produced ß-lactamase VIM-2; the only exceptions were several P. aeruginosa isolates from two centers which expressed VIM-4. The bla_VIM genes resided exclusively within class 1 integrons, and these were located in either chromosomal or plasmid DNA. PCR-restriction fragment length polymorphism study of the variable regions of the integrons, followed by DNA sequencing, revealed the presence of eight different, mostly novel gene cassette arrays, six of which contained bla_VIM-2 and two of which contained bla_VIM-4. The occurrence of the integron variants correlated well with the geographic distribution of the MBL-producing organisms, and this suggested that their emergence in particular parts of the country had been likely due to a number of independent events. The following regional dissemination of MBL producers could be attributed to various phenomena, including their clonal spread, horizontal transmission of resistance determinants, or both. All of the data collected in this study revealed that even at this early stage of detection, the epidemiological situation concerning MBL producers in Poland has already been complex and very dynamic.

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