RmtC 16S rRNA Methyltransferase in Australia

Antimicrobial Agents and Chemotherapy
2008.0

Abstract

Proteus mirabilis isolate JIE273 was recovered in March 2007 from the urine of an inpatient at Blacktown Hospital, Sydney. The patient was born in India, had recently returned to Australia, and had no history of travel to Japan. In vitro susceptibility tests showed high resistance to amikacin, gentamicin, and tobramycin (MICs of 256, 1,024, and 256 μg/ml, respectively), suggesting the presence of a 16S rRNA methyltransferase. PCR screening revealed only the rmtC gene, which was originally discovered in P. mirabilis ARS68 in Japan in 2003 and, to our knowledge, had not been reported elsewhere. The rmtC gene was flanked by a complete, uninterrupted ISEcp1 element, identical to the original sequence (GenBank accession no. AB194779). Attempts to transfer rmtC from JIE273 to Escherichia coli by conjugation or electroporation were unsuccessful. A double-disc synergy test suggested an extended-spectrum β-lactamase, and PCR identified a blaVEB-like gene with a single nucleotide change from blaVEB-4 (GenBank accession no. EF136375), resulting in a conservative substitution (Ile18Val) in the leader peptide. This β-lactamase was designated VEB-6, the first blaVEB-like gene reported in Australia. The coexistence of rmtC-mediated aminoglycoside resistance and VEB-6-mediated β-lactam resistance exacerbates the clinical challenge of antibiotic resistance, as aminoglycosides and β-lactams are often used together to treat critically ill patients.

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