Emergence of VIM-1-carbapenemase-producing Enterobacter cloacae in Tyrol, Austria

The rapid emergence and dissemination of carbapenemase-producing Enterobacter species and other members of the Enterobacteriaceae poses a considerable threat to the care of hospitalized patients and to public health. In this study, Enterobacter isolates demonstrating decreased susceptibility to carbapenems detected at the Division of Hygiene and Medical Microbiology, Innsbruck Medical University, between January 2006 and December 2010 were tested for bla(VIM-1), bla(NDM-1), bla(IMP), bla(KPC) and bla(OXA-48) using a multiplex PCR with published primers. PFGE was performed to determine the genetic relatedness. In total, 33 isolates (28 Enterobacter cloacae and 5 Enterobacter aerogenes) were collected during the study period. From 2006 to 2009, between two and seven isolates were found per year. In 2010, a significant increase of carbapenem-resistant strains was observed (n = 12). The bla(VIM-1) gene was detected in all 28 isolates of E. cloacae. Typing of E. cloacae by PFGE revealed three distinct clusters, the biggest of which contained 18 isolates. These findings demonstrate the emergence of VIM-1-producing Enterobacter in Tyrol, western Austria. The clonal relationship confirms the risk of spread of these organisms and their possible persistence over time.