A carbapenem-resistant Escherichia coli isolate was recovered from rectal swab of a 12-day-old female neonate, which was admitted to a Greek neonatal intensive care unit (NICU). Phenotypic testing, polymerase chain reaction assays with sequencing, and plasmid analysis revealed that the isolate harbored a plasmid-mediated blaVIM-1 metallo-β-lactamase gene. The appearance of a metallo-β-lactamase-producing E. coli in NICU is worrisome. Further surveys are needed to determine whether such Enterobacteriaceae may also be spreading in other NICUs.
Get full access to this article
View all access options for this article.
References
1.
AndersonK.F., LonswayD.R., RasheedJ.K., BiddleJ., JensenB., McDougalL.K., CareyR.B., ThompsonA., StockerS., LimbagoB., PatelJ.B.2007. Evaluation of methods to identify the Klebsiella pneumoniae carbapenemase in Enterobacteriaceae. J. Clin. Microbiol., 45:2723–2725.
2.
CendejasE., Gómez-GilR., Gómez-SánchezP., MingoranceJ.2010. Detection and characterization of Enterobacteriaceae producing metallo-β-lactamases in a tertiary-care hospital in Spain. Clin. Microbiol. Infect., 16:181–183.
ConceiçãoT., BrízioA., DuarteA., BarrosR.2005. First isolation of blaVIM-2 in Klebsiella oxytoca clinical isolates from Portugal. Antimicrob. Agents Chemother., 49:476.
5.
FranklinC., LioliosL., PelegA.Y.2006. Phenotypic detection of carbapenem-susceptible metallo-β-lactamase producing gram-negative bacilli in the clinical laboratory. J. Clin. Microbiol., 44:3139–3144.
6.
GalaniI., SouliM., KoratzanisE., KoratzanisG., ChryssouliZ., GiamarellouH.2007. Emerging bacterial pathogens: Escherichia coli, Enterobacter aerogenes and Proteus mirabilis clinical isolates harbouring the same transferable plasmid coding for metallo-β-lactamase VIM-1 in Greece. J. Antimicrob. Chemother., 58:578–579.
7.
IkonomidisA., TokatlidouD., KristoI., SofianouD., TsakrisA., MantzanaP., PournarasS., ManiatisA. N.2005. Outbreaks in distinct regions due to a single Klebsiella pneumoniae clone carrying a blaVIM-1 metallo-β-lactamase gene. J. Clin. Microbiol., 43:5344–5347.
8.
LauplandK.B., ParkinsM.D., ChurchD.L., GregsonD.B., LouieT.J., ConlyJ.M., ElsayedS., PitoutJ.D.2005. Population-based epidemiological study of infections caused by carbapenem-resistant Pseudomonas aeruginosa in the Calgary Health Region: importance of metallo-β-lactamase (MBL)-producing strains. J. Infect. Dis., 192:1606–1612.
9.
LomaestroB. M., TobinE.H., ShangW., GootzT.2006. The spread of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae to upstate New York. Clin. Infect. Dis., 43:e26–e28.
10.
MiriagouV., TzelepiE., GianneliD., TzouvelekisL.2003. Escherichia coli with a self-transferable, multiresistant plasmid coding for metallo-β-lactamase VIM-1. Antimicrob. Agents Chemother., 47:395–397.
11.
PatzerJ.A., WalshT.R., WeeksJ., DzierzanowskaD., TolemanM.A.2009. Emergence and persistence of integron structures harbouring VIM genes in the Children's Memorial Health Institute, Warsaw, Poland, 1998–2006. J. Antimicrob. Chemother., 63:269–273.
12.
Pérez-PérezF.J., HansonN.D.2002. Detection of plasmid-mediated AmpC β-lactamase genes in clinical isolates by using multiplex PCR. J. Clin. Microbiol., 40:2153–2162.
13.
QueenanA.M., BushK.2007. Carbapenemases: the versatile β-lactamases. Clin. Microbiol. Rev., 20:440–458.
14.
ScoulicaE.V., NeonakisI.K., GikasA.I., TselentisY.J. 2004. Spread of blaVIM-1-producing E. coli in a university hospital in Greece. Genetic analysis of the integron carrying the blaVIM-1 metallo-β-lactamase gene. Diagn. Microbiol. Infect. Dis., 48:167–172.
15.
TatoM., CoqueT.M., Ruiz-GarbajosaP., PintadoV., CoboJ., SaderH.S., JonesR.N., BaqueroF., CantonR.2007. Complex clonal and plasmid epidemiology in the first outbreak of Enterobacteriaceae infection involving VIM-1 metallo-β-lactamase in Spain: Toward endemicity?Clin. Infect. Dis, 45:1171–1178.
16.
TsakrisA., IkonomidisA., PoulouA., SpanakisN., PournarasS., MarkouF.2007. Transmission in the community of clonal Proteus mirabilis carrying VIM-1 metallo-β-lactamase. J. Antimicrob. Chemother., 60:136–139.
17.
TsakrisA., KristoI., PoulouA., Themeli-DigalakiK., IkonomidisA., PetropoulouD., PournarasS., SofianouD.2009. Evaluation of boronic acid disk tests for differentiating KPC-possessing Klebsiella pneumoniae isolates in the clinical laboratory. J. Clin. Microbiol., 47:362–367.
18.
TsakrisA., PournarasS., WoodfordN., PalepouM.F.I., BabiniG.S., DouboyasJ., LivermoreD.M.2000. Outbreak of infections caused by Pseudomonas aeruginosa producing VIM-1 carbapenemase in Greece. J. Clin. Microbiol., 38:1290–1292.
19.
TzelepiE., MaganaC., PlatsoukaE., SofianouD., PaniaraO., LegakisN.J., VatopoulosA.C., TzouvelekisL.S.2003. Extended-spectrum β-lactamase types in Klebsiella pneumoniae and Escherichia coli in two Greek hospitals. Int. J. Antimicrob. Agents, 21:285–288.
20.
VittiD., ProtonotariouE., SofianouD.2009. Carbapenem-resistant Escherichia coli carrying the blaVIM-1 gene in the community. Int. J. Antimicrob. Agents, 34:187–188.
21.
WalshT.R., TolemanM.A., PoirelL., NordmannP.2005. Metallo-β-lactamases: the quiet before the storm?Clin. Microbiol. Rev., 18:306–325.
22.
WalshT.R., TolemanM.A., HryniewiczW., BennettP.M., JonesR.N.2003. Evolution of an integron carrying blaVIM-2 in Eastern Europe: report from the SENTRY Antimicrobial Surveillance Program. J. Antimicrob. Chemother., 52:116–119.
23.
YanJ.J., HsuehP.R., KoW.C., LuhK.T., TsaiS.H., WuH.M., WuJ.J.2001. Metallo-β-lactamases in clinical Pseudomonas isolates in Taiwan and identification of VIM-3, a novel variant of the VIM-2 enzyme. Antimicrob. Agents Chemother., 45:2224–2228.
