IMP-15-Producing Pseudomonas aeruginosa Strain Isolated in a U.S. Medical Center: a Recent Arrival from Mexico

Antimicrobial Agents and Chemotherapy
2008.0

Abstract

Carbonapenem resistance due to metallo-β-lactamase (M-L)-encoding genes is rare in Pseudomonas aeruginosa strains from the United States. In this study, we characterized an IMP-15-producing P. aeruginosa strain (1750J) isolated from a medical center in Kentucky. A total of 50 meropenem-nonsusceptible P. aeruginosa isolates from 2001 to 2005 were evaluated via susceptibility testing, M-L screening (using M-L Etest strips), PCR, sequencing, and pulsed-field gel electrophoresis (PFGE). Only strain 1750J showed M-L production, with a significant reduction in imipenem MIC when combined with EDTA. PCR and sequencing revealed blaIMP-15 was located in the second position of a 6-kb class 1 integron carrying additional resistance genes (aacA7, qacH, aacA4, blaOXA-2, aadA1). This integron structure matched that of an IMP-15-producing P. aeruginosa strain from Guadalajara, Mexico, and PFGE confirmed the two isolates were identical, indicating the infection was acquired in Mexico. The UKHC's antimicrobial control program kept meropenem resistance below the national average. We conclude that while M-L-associated carbapenem resistance remains unusual in the U.S., M-L screening should be performed on multidrug-resistant, carbapenem-resistant strains from patients returning from endemic areas to implement infection control measures.

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