First outbreak of VIM-2 metallo-β-lactamase-producing Pseudomonas aeruginosa in the Netherlands: Microbiology, epidemiology and clinical outcomes

A. K. Van Der Bij, R. Van Mansfeld, G. Peirano, W. H.F. Goessens, J. A. Severin, J. D.D. Pitout, R. Willems, M. Van Westreenen

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Abstract

This study was designed to investigate the prevalence and characteristics of metallo-β-lactamase (MBL)-producing Pseudomonas aeruginosa in a tertiary care centre in The Netherlands, a country that is considered to have a low prevalence of antibiotic-resistant bacteria. Imipenem-resistant P. aeruginosa 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 P. aeruginosa isolate that was included in the study. In total, 106 imipenem-resistant P. aeruginosa isolates were included. The blaVIM-2 gene was detected in 35/106 isolates (33%) and was associated with integrons. Compared with non-MBL-producing imipenem-resistant P. aeruginosa, 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 P. aeruginosa in The Netherlands. Once introduced, VIM-2 MBL-producing P. aeruginosa cause significant infections and are easily spread within the hospital setting.

Original languageEnglish
Pages (from-to)513-518
Number of pages6
JournalInternational Journal of Antimicrobial Agents
Volume37
Issue number6
DOIs
Publication statusPublished - Jun 2011

Keywords

  • Metallo-β-lactamase
  • Nosocomial
  • Prevalence
  • Pseudomonas aeruginosa
  • VIM-2

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