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Antimicrobial Agents and Chemotherapy, March 2007, p. 852-856, Vol. 51, No. 3
0066-4804/07/$08.00+0     doi:10.1128/AAC.01345-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Coproduction of Novel 16S rRNA Methylase RmtD and Metallo-ß-Lactamase SPM-1 in a Panresistant Pseudomonas aeruginosa Isolate from Brazil{triangledown}

Yohei Doi,1* Doroti de Oliveira Garcia,2 Jennifer Adams,1 and David L. Paterson1

Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213,1 Instituto Adolfo Lutz, São Paulo, Brazil2

Received 26 October 2006/ Returned for modification 29 November 2006/ Accepted 30 November 2006

Serious infections with Pseudomonas aeruginosa are frequently treated with the combination of a ß-lactam antimicrobial and an aminoglycoside. P. aeruginosa strain PA0905 was isolated in 2005 from an inpatient in Brazil. It showed a panresistant phenotype that included resistance to ß-lactams, aminoglycosides, and fluoroquinolones. The ß-lactam resistance was conferred by the production of the metallo-ß-lactamase SPM-1. No inhibitory zone was observed when a disk diffusion test was performed with the semisynthetic aminoglycoside arbekacin, raising suspicion of 16S rRNA methylase production. A cloning experiment subsequently revealed the presence of a novel 16S rRNA methylase, RmtD, which accounted for the high-level resistance to all 4,6-disubstituted deoxystreptamine aminoglycosides, such as amikacin, tobramycin, and gentamicin. RmtD shared a moderate degree of identity with RmtA, another 16S rRNA methylase that was initially reported to occur in P. aeruginosa in Japan in 2003. This is the first identification of aminoglycoside resistance mediated by a 16S rRNA methylase in South America. This is also the first report to document coproduction of a metallo-ß-lactamase and a 16S rRNA methylase, a combination that would severely compromise therapeutic options for the infected patients.

* Corresponding author. Mailing address: Division of Infectious Diseases, University of Pittsburgh Medical Center, Falk Medical Building Suite 3A, 3601 Fifth Avenue, Pittsburgh PA 15213. Phone: (412) 648-6401. Fax: (412) 648-6399. E-mail: doiy{at}dom.pitt.edu.

{triangledown} Published ahead of print on 11 December 2006.

Antimicrobial Agents and Chemotherapy, March 2007, p. 852-856, Vol. 51, No. 3
0066-4804/07/$08.00+0     doi:10.1128/AAC.01345-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.



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