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Carbapenem-Resistant Pseudomonas aeruginosa–Carrying VIM-2 Metallo-β-Lactamase Determinants, Croatia

Centers for Disease Control and Prevention
Publication Date
DOI: 10.3201/eid0908.020373
  • Letters To The Editor
  • Biology
  • Medicine


Letters.qxd 1022 Emerging Infectious Diseases • Vol. 9, No. 8, August 2003 LETTERS Carbapenem- Resistant Pseudomonas aeruginosa–Carrying VIM-2 Metallo-β- Lactamase Determinants, Croatia To the Editor: Carbapenem- hydrolyzing enzymes of the VIM- type (six different variants are known: VIM-1, VIM-2, VIM-3, VIM-4, VIM- 5, and VIM-6) are new molecular class B metallo-β-lactamases. These enzymes have recently been identified in carbapenem-resistant isolates of Pseudomonas aeruginosa and other gram-negative nonfermenters from European countries in the Mediterranean basin (Italy, France, Greece, Spain, Portugal, and Turkey), as well as in Far East countries (Korea, Taiwan, and Singapore) and the United States (1–3, Midilli et al., GenBank accession no. AY144612, Koh et al., GenBank accession no. AY165025). Similar to blaIMP, blaVIM genes are located on mobile gene cas- settes inserted in the variable regions of integrons (1), a condition that pro- vides a wide potential for expression and dissemination in gram-negative pathogens. VIM enzymes possess the broadest range of substrate hydrolysis and can degrade virtually all β-lac- tams, except monobactams (4). According to a recent report, the overall resistance rate to imipenem in P. aeruginosa isolated from 17 repre- sentative laboratories in Croatia was 11% (range 0%–20%) (5). However, molecular basis of carbapenem resist- ance was not investigated. In October 2000, two P. aerugi- nosa isolates with an unusual resist- ance profile were isolated from two Croatian patients (66 and 74 years of age, respectively) who underwent hysterectomies at the Split University Hospital. Both isolates were cultured from urine a week after surgery; a uri- nary catheter had been used for both patients who had become febrile and had signs and symptoms of urinary tract infection. Analysis of the macrorestriction profiles of chromoso- mal DNA of the two isolates by pulsed-field gel electrophoresis, car- ried out as described previously (6), indicate

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