First outbreak of VIM-2 metallo-β-lactamase-producing in The Netherlands: microbiology, epidemiology and clinical outcomes

This study was designed to investigate the prevalence and characteristics of metallo-β-lactamase (MBL)-producing in a tertiary care centre in The Netherlands, a country that is considered to have a low prevalence of antibiotic-resistant bacteria. Imipenem-resistant isolates cultured from clinical sp...

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Veröffentlicht in:International journal of antimicrobial agents 2011-04
Hauptverfasser: van Der Bij, A.K., van Mansfeld, R., Peirano, G., Goessens, W.H.F., Severin, J.A., Pitout, J.D.D., Willems, R., van Westreenen, M.
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container_title International journal of antimicrobial agents
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creator van Der Bij, A.K.
van Mansfeld, R.
Peirano, G.
Goessens, W.H.F.
Severin, J.A.
Pitout, J.D.D.
Willems, R.
van Westreenen, M.
description This study was designed to investigate the prevalence and characteristics of metallo-β-lactamase (MBL)-producing in a tertiary care centre in The Netherlands, a country that is considered to have a low prevalence of antibiotic-resistant bacteria. Imipenem-resistant isolates cultured from clinical specimens during 2008-2009 were analysed phenotypically and molecularly by polymerase chain reaction (PCR) with sequencing. Genotyping was performed by multiple-locus variable-number tandem repeat (VNTR) analysis (MLVA). Clinical information was obtained by electronic chart review for all patients infected or colonised with an imipenem-resistant isolate that was included in the study. In total, 106 imipenem-resistant isolates were included. The gene was detected in 35/106 isolates (33%) and was associated with integrons. Compared with non-MBL-producing imipenem-resistant , VIM-2 MBL-producing isolates showed higher rates of multidrug resistance. Patients with VIM-2 MBL-producing isolates were more likely to be admitted to the Intensive Care Unit (ICU) and had a higher risk of invasive infection, including development of bacteraemia. MLVA identified two separate VIM-2 MBL-producing clones, responsible for outbreaks in the ICU but also affecting 10 other departments. This is the first reported outbreak of VIM-2 MBL-producing in The Netherlands. Once introduced, VIM-2 MBL-producing cause significant infections and are easily spread within the hospital setting.
doi_str_mv 10.1016/j.ijantimicag.2011.02.010
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Imipenem-resistant isolates cultured from clinical specimens during 2008-2009 were analysed phenotypically and molecularly by polymerase chain reaction (PCR) with sequencing. Genotyping was performed by multiple-locus variable-number tandem repeat (VNTR) analysis (MLVA). Clinical information was obtained by electronic chart review for all patients infected or colonised with an imipenem-resistant isolate that was included in the study. In total, 106 imipenem-resistant isolates were included. The gene was detected in 35/106 isolates (33%) and was associated with integrons. Compared with non-MBL-producing imipenem-resistant , VIM-2 MBL-producing isolates showed higher rates of multidrug resistance. Patients with VIM-2 MBL-producing isolates were more likely to be admitted to the Intensive Care Unit (ICU) and had a higher risk of invasive infection, including development of bacteraemia. MLVA identified two separate VIM-2 MBL-producing clones, responsible for outbreaks in the ICU but also affecting 10 other departments. This is the first reported outbreak of VIM-2 MBL-producing in The Netherlands. 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title First outbreak of VIM-2 metallo-β-lactamase-producing in The Netherlands: microbiology, epidemiology and clinical outcomes
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