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J Antimicrob Chemother. 2005 Dec;56(6):1148-51. Epub 2005 Oct 20.

Outbreak of carbapenem-resistant Pseudomonas aeruginosa producing SPM-1 metallo-{beta}-lactamase in a teaching hospital in southern Brazil.

Author information

1
Infectious Diseases Service, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil. apzavascki@terra.com.br

Abstract

OBJECTIVES:

To describe the first nosocomial outbreak of Pseudomonas aeruginosa producing SPM-1 metallo-beta-lactamase (MBL) in southern Brazil.

PATIENTS AND METHODS:

From January to October 2004, carbapenem-resistant P. aeruginosa (CRPA) were recovered from hospitalized patients. Mortality, site of infection/colonization, patient location and susceptibility profiles were analysed. A sample of CRPA was screened for MBL production, evaluated for the presence of bla(SPM-1), bla(IMP-1) and bla(VIM-2) genes by PCR and submitted for molecular typing by DNA macrorestriction.

RESULTS:

A total of 135 CRPA (one isolate per patient) were recovered. Two major antibiotic susceptibility profiles comprised 63.7% of the isolates (susceptibility to polymyxin B and aztreonam, and susceptibility only to polymyxin B). Thirty-five CRPA were screened for MBL production (10 isolates from April, June and July, and 25 from September and October) and 27 (77.1%) proved to be positive for MBL production. Twenty-one of the 24 CRPA tested carried the bla(SPM-1) gene. The mortality of patients with CRPA was 48.1% and no variable was associated with death. Molecular typing revealed the presence of a clone with four related subtypes among the bla(SPM-1)-positive CRPA.

CONCLUSIONS:

The prevalence of MBL production by CRPA is high and horizontal transmission is a major determinant for the spread of SPM-1 CRPA among patients in this institution. As infection control measures failed to control the spread of CRPA, continuous surveillance for MBL production is warranted.

PMID:
16239284
DOI:
10.1093/jac/dki390
[Indexed for MEDLINE]

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