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[First outbreak report of VIM-1 metallo-beta-lactamase producing Pseudomonas aeruginosa in Japan]

Kanji Miki1, Hiroshi Takegawa, Masaaki Etoh

  • 1Department of Clinical Laboratory, Kobe City Medical Center General Hospital.

Kansenshogaku Zasshi. the Journal of the Japanese Association for Infectious Diseases
|January 14, 2011
PubMed

Insights

A VIM-1 metallo-beta-lactamase (MBL) outbreak in Pseudomonas aeruginosa occurred in 35 patients. Multidrug-resistant strains were identified, but infection control measures successfully contained the outbreak.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Metallo-beta-lactamase (MBL) producing Pseudomonas aeruginosa poses a significant threat due to its resistance to a wide range of antibiotics.
  • The emergence of VIM-1 MBL in clinical settings necessitates surveillance and outbreak management strategies.

Purpose of the Study:

  • To report and characterize an outbreak of VIM-1 MBL producing Pseudomonas aeruginosa at Kobe City Medical Center General Hospital.
  • To investigate the antimicrobial resistance patterns and genetic relatedness of the isolated strains.

Main Methods:

  • Isolation and identification of Pseudomonas aeruginosa strains from patient samples.
  • Antimicrobial susceptibility testing against various antibiotic classes.
  • Detection of metallo-beta-lactamase (MBL) using phenotypic screening (sodium mercaptoacetate disk diffusion) and genotypic confirmation (PCR for bla(VIM-1)).
  • Molecular typing using pulsed-field gel electrophoresis (PFGE) to assess strain relatedness.

Main Results:

  • Thirty-five cases of VIM-1 MBL producing Pseudomonas aeruginosa infection were identified between September 2007 and July 2008.
  • The majority of isolates exhibited high-level resistance to beta-lactams, aminoglycosides, and fluoroquinolones, with one isolate showing susceptibility to amikacin.
  • All 35 strains tested positive for the bla(VIM-1) gene via PCR.
  • PFGE analysis revealed that all isolates were indistinguishable, confirming a clonal outbreak.
  • Implementation of infection control interventions led to the successful control of the outbreak.

Conclusions:

  • A significant outbreak of VIM-1 MBL producing Pseudomonas aeruginosa occurred, characterized by extensive multidrug resistance.
  • Molecular typing confirmed a single clone responsible for the outbreak, highlighting the importance of rapid detection and containment.
  • Effective infection control measures were crucial in controlling the spread of this highly resistant pathogen.

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