 |
The Journal of the Japanese Society for Clinical Microbiology |
Biblioraphy Information
| ArticleTitle |
Molecular epidemiology and clinical characteristics of metallo-β-lactamase producing Enterobacter hormaechei/xiangfangensis isolated from four patients at an intensive care unit in Japan |
| Language |
J |
| AuthorList |
Narito Kagawa1), Nobuaki Mori2), Kotaro Aoki3), Akiko Higuchi1), Moe Sue1), Momoko Katsuta1), Ayumi Yoshizumi3), Yoshikazu Ishii3), Kazuhiro Tateda3), Yasuko Aoki2) |
| Affiliation |
1) Department of Clinical Laboratory, National Hospital Organization, Tokyo Medical Center
2) Department of General Internal Medicine, National Hospital Organization, Tokyo Medical Center
3) Department of Microbiology and Infectious Diseases, Toho University School of Medicine |
| Publication |
J.J.C.M.: 27 (2), 81-87, 2017 |
| Received |
September 14, 2016 |
| Accepted |
January 19, 2017 |
| Abstract |
IMP-type metallo-β-lactamase (MBL) producing Enterobacteriaceae have been reported to be spread in Japan; however, the molecular epidemiology and clinical characteristics were unknown. We herein present four cases of IMP-1 type MBL producing Enterobacter cloacae complex isolated from an intensive care unit in a Japanese hospital between August and October 2013. To identity the molecular and clinical characteristics, we performed 16Sr RNA gene sequencing, antimicrobial susceptibility testing, detection as MBL and IMP-type, pulsed field gel electrophoresis (PFGE), antimicrobial resistance profiling using a next-generation sequencer, and investigated medical records. The sequence of the isolates' 16Sr RNA genes exhibited the greatest similarity to E. hormaechei (99.02%) and E. xiangfangensis (99.58%). Isolates produced IMP-1 type MBL and were resistant to minocycline. PFGE analysis showed that all the isolates were clonal. The MBL gene blaIMP-1 was found to be present in a class 1 integron. The MBL gene cassette was located upstream of an array gene cassette containing aac (6') IIc, qacEΔ1, and sul1. Compared to the gyrA, gyrB, parC, and parE of E. cloacae ATCC13047, the isolates had no change in the quinolone resistance-determining regions. All patients had been exposed to at least one medical device and a broad-spectrum antimicrobial. Patients in three cases were considered to have an infection. They received levofloxacin based on in vitro susceptibility and overcame infection. However, three patients died of the underlying disease during hospitalization. Our report suggests the possibility of nosocomial spread because PEGE showed clonality and the MBL producing Enterobacteriaceae had not been isolated in these patients in the past. |
| Keywords |
Enterobacter cloacae complex, Enterobacter hormaechei/Enterobacter xiangfangensis |
|
