Elsevier

Pathology

Volume 47, Issue 2, February 2015, Pages 156-160
Pathology

Molecular surveillance for carbapenemase genes in carbapenem resistant Pseudomonas aeruginosa in Australian patients with cystic fibrosis

https://doi.org/10.1097/PAT.0000000000000216Get rights and content

Summary

The aim of this study was to assess the prevalence of acquired carbapenemase genes amongst carbapenem non-susceptible Pseudomonas aeruginosa isolates in Australian patients with cystic fibrosis (CF). Cross-sectional molecular surveillance for acquired carbapenemase genes was performed on CF P. aeruginosa isolates from two isolate banks comprising: (i) 662 carbapenem resistant P. aeruginosa isolates from 227 patients attending 10 geographically diverse Australian CF centres (2007–2009), and (ii) 519 P. aeruginosa isolates from a cohort of 173 adult patients attending one Queensland CF clinic in 2011. All 1189 P. aeruginosa isolates were tested by polymerase chain reaction (PCR) protocols targeting ten common carbapenemase genes, as well the Class 1 integron intl1 gene and the aadB aminoglycoside resistance gene. No carbapenemase genes were identified among all isolates tested. The intl1 and aadB genes were frequently detected and were significantly associated with the AUST-02 strain (OR 24.6, 95% CI 9.3–65.6; p < 0.0001) predominantly from Queensland patients. Despite the high prevalence of carbapenem resistance in P. aeruginosa in Australian patients with CF, no acquired carbapenemase genes were detected in the study, suggesting chromosomal mutations remain the key resistance mechanism in CF isolates. Systematic surveillance for carbapenemase-producing P. aeruginosa in CF by molecular surveillance is ongoing.

References (35)

  • A. Carattoli et al.

    Isolation of NDM-1-producing Pseudomonas aeruginosa sequence type ST235 from a stem cell transplant patient in Italy, May 2013

    Euro Surveill

    (2013)
  • H. Rieber et al.

    Emergence of metallo-beta-lactamases GIM-1 and VIM in multidrug-resistant Pseudomonas aeruginosa in North Rhine-Westphalia, Germany

    J Antimicrob Chemother

    (2012)
  • S. Herbert et al.

    Large outbreak of infection and colonization with gram-negative pathogens carrying the metallo-beta-lactamase gene blaIMP-4 at a 320-bed tertiary hospital in Australia

    Infect Control Hosp Epidemiol

    (2007)
  • A.P. Zavascki et al.

    Outbreak of carbapenemresistant Pseudomonas aeruginosa producing SPM-1 metallo-{beta}-lacta-mase in a teaching hospital in southern Brazil

    J Antimicrob Chemother

    (2005)
  • L. Poirel et al.

    Emergence of KPC-producing Pseudomonas aeruginosa in the United States

    Antimicrob Agents Che-mother

    (2010)
  • K.B. Laupland et al.

    Population-based epidemio-logical study of infections caused by carbapenem-resistant Pseudomonas aeruginosa in the Calgary Health Region: importance of metallo-beta-lactamase (MBL)-producing strains

    J Infect Dis

    (2005)
  • A.Y. Peleg et al.

    Dissemination of the metallo-beta-lactamase gene blaIMP-4 among gram-negative pathogens in a clinical setting in Australia

    Clin Infect Dis

    (2005)
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