Skip to main page content

• HOME
• Current Issue
• Archive
• Alerts
• About ASM
• Contact us
• Tech Support
• Journals.ASM.org

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Samuelsen, O. Articles by Sundsfjord, A. Search for Related Content PubMed PubMed Citation Articles by Samuelsen, O. Articles by Sundsfjord, A.

 Previous Article  |  Next Article 

Antimicrobial Agents and Chemotherapy, January 2009, p. 331-332, Vol. 53, No. 1
0066-4804/09/$08.00+0     doi:10.1128/AAC.00785-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

LETTER TO THE EDITOR

The First Metallo-β-Lactamase Identified in Norway Is Associated with a TniC-Like Transposon in a Pseudomonas aeruginosa Isolate of Sequence Type 233 Imported from Ghana

Top LETTER Nucleotide sequence accession... REFERENCES

 
Metallo-β-lactamases (MBLs) are an emerging problem among various clinically important gram-negative bacilli, such as Pseudomonas aeruginosa, Acinetobacter spp., and Enterobacteriaceae (8).

Scandinavian countries are renowned for their low level of antibiotic resistance (1), and previous reports on the emergence of new resistance mechanisms have been associated with strain import, such as with the first Swedish MBL, derived from Greece (3).

As part of an ongoing national study of MBLs in clinical isolates of P. aeruginosa, the National Reference Centre received a carbapenem-resistant isolate (K34-7) from the Ullevål University Hospital in the autumn of 2006. The isolate was recovered from tracheal secretions upon admission of a patient who transferred to the hospital after prolonged hospitalization in Ghana. The isolate is therefore likely to have been imported to Norway from Ghana.

Susceptibility testing of the isolate using Etests (AB Biodisk, Solna, Sweden) showed that the isolate was susceptible only to colistin, intermediate to aztreonam, and resistant to other β-lactams (imipenem-meropenem MIC, >32 µg/ml), aminoglycosides, and fluoroquinolones according to EUCAST clinical breakpoints. The isolate had a positive MBL Etest ratio, and MBL production was confirmed by spectrophotometric analysis of imipenem hydrolysis by crude cell extracts and subsequent inhibition by EDTA (11). The sequence of the bla_VIM-2 gene was confirmed by PCR using consensus primers for bla_VIM, and sequence analysis of the genetic context using oligonucleotides for the 5' conserved sequence (5'CS), the 3'CS, bla_VIM, and tniC showed that the bla_VIM-2 gene was located in an unusual class 1 integron flanked by the tni module similar to Tn402 (7) and not the normal 3'CS end (fused qacE1-sul1). PCR linking bla_VIM-2 to tniA, orf6, and tniB and sequencing confirmed that the whole tni module was present. The gene cassette array of aacA7-bla_VIM-2-dhfrB5-aacC-A5 is identical to other TniC-like transposons found in isolates from the United States (6), Russia (GenBank accession no. DQ522233), and Taiwan (12) and almost identical to a TniC-like transposon found in an Indian isolate (10). Multilocus sequence typing showed that K34-7 belonged to ST233, which is not part of any clonal complexes; however, Russian isolates with the same transposon belong to ST235, which is part of a clonal complex harboring MBL isolates from several countries in Europe (2, 4, 9). Further, pulsed-field gel electrophoresis (PFGE) analysis (SpeI digestion) and serotyping of K34-7 and isolates possessing TniC-like transposons from Russia (GenBank accession no. DQ522233) and Taiwan (12) showed that the isolates had different PFGE profiles and were of different serotypes (Russian isolate, O11; Taiwan isolate, O2; and K34-7, O6). Thus, the appearance of this TniC-like transposon in unrelated P. aeruginosa isolates suggests that the transposon is itself transferable and also responsible for the dissemination of bla_VIM-2. The chromosomal location of the TniC-like transposon was confirmed by hybridization of a radiolabeled bla_VIM-2 probe to a chromosomal band larger than 1 megabase after I-Ceu-1 digestion of K34-7 genomic DNA and PFGE (5; data not shown). In conclusion, this study highlights the importance of TniC-like transposons in the global dissemination of bla_VIM-2 and also the contribution of human population dynamics in spreading MBL genes.

(Part of this study was presented at the 17th European Congress of Clinical Microbiology and Infectious Diseases, Munich, Germany.)

Top LETTER Nucleotide sequence accession... REFERENCES

 
The nucleotide sequence determined in this study was deposited in the EMBL database under accession no. FM165436.

 
Ø.S. is supported by a grant from the Northern Norway Regional Health Authority Medical Research Program, and M.A.T. is funded by EU grant LSHM-CT-2005-018705.

The Taiwan isolate harboring the TniC-like transposon was kindly donated by Jing-Jou Yan.

 
Published ahead of print on 17 November 2008.

Top LETTER Nucleotide sequence accession... REFERENCES

 

1
1. European Antimicrobial Resistance Surveillance System (EARSS). 2007. EARSS annual report 2006, p. 1-162. EARSS, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
2
2. Giske, C. G., B. Libisch, C. Colinon, E. Scoulica, L. Pagani, M. Fuzi, G. Kronvall, and G. M. Rossolini. 2006. Establishing clonal relationships between VIM-1-like metallo-β-lactamase-producing Pseudomonas aeruginosa strains from four European countries by multilocus sequence typing. J. Clin. Microbiol. 44:4309-4315.[Abstract/Free Full Text]
3
3. Giske, C. G., M. Rylander, and G. Kronvall. 2003. VIM-4 in a carbapenem-resistant strain of Pseudomonas aeruginosa isolated in Sweden. Antimicrob. Agents Chemother. 47:3034-3035.[Free Full Text]
4
4. Libisch, B., J. Watine, B. Balogh, M. Gacs, M. Muzslay, G. Szabo, and M. Fuzi. 2008. Molecular typing indicates an important role for two international clonal complexes in dissemination of VIM-producing Pseudomonas aeruginosa clinical isolates in Hungary. Res. Microbiol. 159:162-168.[Medline]
5
5. Liu, S.-L., and K. E. Sanderson. 1995. I-CeuI reveals conservation of the genome of independent strains of Salmonella typhimurium. J. Bacteriol. 177:3355-3357.[Abstract/Free Full Text]
6
6. Lolans, K., A. M. Queenan, K. Bush, A. Sahud, and J. P. Quinn. 2005. First nosocomial outbreak of Pseudomonas aeruginosa producing an integron-borne metallo-β-lactamase (VIM-2) in the United States. Antimicrob. Agents Chemother. 49:3538-3540.[Abstract/Free Full Text]
7
7. Radstrom, P., O. Skold, G. Swedberg, J. Flensburg, P. H. Roy, and L. Sundstrom. 1994. Transposon Tn5090 of plasmid R751, which carries an integron, is related to Tn7, Mu, and the retroelements. J. Bacteriol. 176:3257-3268.[Abstract/Free Full Text]
8
8. Rossolini, G. M., and J. D. Docquier. 2007. Class B β-lactamases, p. 115-144. In R. A. Bonomo and M. E. Tomasky (ed.), Enzyme-mediated resistance to antibiotics: mechanisms, dissemination, and prospects for inhibition. ASM Press, Washington, DC.
9
9. Shevchenko, O., and M. Edelstein. 2007. Epidemic population structure of MBL-producing Pseudomonas aeruginosa in Russia. Abstr. 47th Intersci. Conf. Antimicrob. Agents Chemother., abstr. C2-1499.
10
10. Toleman, M. A., H. Vinodh, U. Sekar, V. Kamat, and T. R. Walsh. 2007. bla_VIM-2-harboring integrons isolated in India, Russia, and the United States arise from an ancestral class 1 integron predating the formation of the 3' conserved sequence. Antimicrob. Agents Chemother. 51:2636-2638.[Abstract/Free Full Text]
11
11. Toleman, M. A., D. Biedenbach, D. M. Bennett, R. N. Jones, and T. R. Walsh. 2005. Italian metallo-beta-lactamases: a national problem? Report from the SENTRY Antimicrobial Surveillance Programme. J. Antimicrob. Chemother. 55:61-70.
12
12. Yan, J. J., P. R. Hsueh, J. J. Lu, F. Y. Chang, W. C. Ko, and J. J. Wu. 2006. Characterization of acquired β-lactamases and their genetic support in multidrug-resistant Pseudomonas aeruginosa isolates in Taiwan: the prevalence of unusual integrons. J. Antimicrob. Chemother. 58:530-536.[Abstract/Free Full Text]

						Ørjan Samuelsen* Liselotte Buarø Reference Centre for Detection of Antimicrobial Resistance Department of Microbiology and Infection Control University Hospital of North Norway Tromsø, Norway Mark A. Toleman School of Medicine Department of Medical Microbiology Cardiff University Cardiff, United Kingdom Christian G. Giske Department of Clinical Microbiology Karolinska University Hospital Stockholm, Sweden Nils O. Hermansen Department of Microbiology Ullevaal University Hospital Oslo, Norway Timothy R. Walsh School of Medicine Department of Medical Microbiology Cardiff University Cardiff, United Kingdom Arnfinn Sundsfjord Department of Microbiology and Virology IMB Faculty of Medicine University of Tromsø Tromsø, Norway
						* Phone: 47 776 27043 Fax: 47 776 27015 E-mail: orjan.samuelsen{at}unn.no

---

Antimicrobial Agents and Chemotherapy, January 2009, p. 331-332, Vol. 53, No. 1
0066-4804/09/$08.00+0     doi:10.1128/AAC.00785-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

This article has been cited by other articles:

• Samuelsen, O., Naseer, U., Tofteland, S., Skutlaberg, D. H., Onken, A., Hjetland, R., Sundsfjord, A., Giske, C. G. (2009). Emergence of clonally related Klebsiella pneumoniae isolates of sequence type 258 producing plasmid-mediated KPC carbapenemase in Norway and Sweden. J Antimicrob Chemother 63: 654-658 [Abstract] [Full Text]  

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Samuelsen, O. Articles by Sundsfjord, A. Search for Related Content PubMed PubMed Citation Articles by Samuelsen, O. Articles by Sundsfjord, A.