In:
Journal of Clinical Microbiology, American Society for Microbiology, Vol. 47, No. 11 ( 2009-11), p. 3514-3519
Abstract:
The aim of this study was to ascertain the incidence and clinical significance of metallo-β-lactamases among Enterobacter strains isolated from patients with nosocomial infections. We prospectively collected data on patients with Enterobacter infection during a 13-month period. All of the strains were investigated for antibiotic susceptibility, the presence and expression of metallo-β-lactamases, and clonality. Of 29 infections (11 involving the urinary tract, 7 pneumonias, 3 skin/soft tissue infections, 3 intra-abdominal infections, 3 bacteremias, and 2 other infections), 7 (24%) were caused by Enterobacter cloacae strains harboring a bla VIM-1 gene associated or not with a bla SHV12 gene. Infections caused by VIM-1-producing strains were more frequently associated with a recent prior hospitalization ( P = 0.006), cirrhosis ( P = 0.03), relapse of infection ( P 〈 0.001), and more prolonged duration of antibiotic therapy ( P = 0.01) than were other infections. All of the isolates were susceptible to imipenem and meropenem and had bla VIM-1 preceded by a weak P1 promoter and inactivated P2 promoters. Most VIM-1-producing Enterobacter isolates belonged to a main clone, but four different clones were found. Multiclonal VIM-1-producing E. cloacae infections are difficult to diagnose due to an apparent susceptibility to various beta-lactams, including carbapenems, and are associated with a high relapse rate and a more prolonged duration of antibiotic therapy.
Type of Medium:
Online Resource
ISSN:
0095-1137
,
1098-660X
DOI:
10.1128/JCM.01193-09
Language:
English
Publisher:
American Society for Microbiology
Publication Date:
2009
detail.hit.zdb_id:
1498353-9
SSG:
12
