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Multiclonal spread of VIM-1-producing Enterobacter cloacae isolates associated with In624 and In488 integrons located

Jennifer Villa1, Esther Viedma1, Patricia Brañas1

  • 1Servicio de Microbiología Clínica, Hospital Universitario 12 de Octubre, Avenida de Córdoba sn, Madrid 28041, Spain.

International Journal of Antimicrobial Agents
|April 8, 2014
PubMed

Insights

Metallo-beta-lactamases (MBLs) like VIM-1 are emerging in Enterobacter cloacae, contributing to carbapenem resistance. Horizontal gene transfer via plasmids, not just clone spread, drives this antimicrobial resistance in hospitals.

Area of Science:

  • Microbiology
  • Molecular Biology
  • Epidemiology

Background:

  • Enterobacter cloacae isolates exhibiting resistance to beta-lactams and reduced carbapenem susceptibility emerged between 2007-2012.
  • Metallo-beta-lactamases (MBLs) were investigated as a potential driver of this resistance profile.

Purpose of the Study:

  • To investigate the role of MBLs in the resistance of Enterobacter cloacae to beta-lactams and carbapenems.
  • To characterize the genetic diversity, resistance mechanisms, and genetic environment of VIM-1 producing E. cloacae.

Main Methods:

  • Molecular epidemiological study including PCR for resistance genes (blaVIM-1, blaVIM-2, blaKPC).
  • Molecular typing (e.g., MLST) to assess strain diversity.
  • Investigation of the genetic environment of blaVIM-1, including integron structures.
  • Conjugal transfer experiments to identify mobile genetic elements.

Main Results:

  • Out of 73 E. cloacae isolates, 37 harbored blaVIM-1, 1 had blaVIM-2, and 5 had blaKPC.
  • High clonal diversity was observed among blaVIM-1 carrying isolates.
  • Two integron structures (In624 and In488) containing blaVIM-1 were identified.
  • blaVIM-1 was associated with a ~300 kb IncHI2 conjugative plasmid, common in Spanish hospitals.

Conclusions:

  • Horizontal gene transfer of blaVIM-1 via IncHI2 plasmids, rather than clonal spread, is likely responsible for its dissemination.
  • Findings have significant implications for hospital infection control strategies against carbapenem-resistant Enterobacteriaceae.
Keywords:
Enterobacter cloacaeIncHI2 plasmidIntegronVIM-1

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