Emergence of Carbapenem-Resistant Enterobacter cloacae Carrying VIM-4 Metallo-b-Lactamase and SHV-2a Extended-Spectrum b-Lactamase in a Conjugative Plasmid

• Published in: Microbial drug resistance (Larchmont, N.Y.) Vol. 13; no. 4; pp. 221 - 225
• Main Authors: Ikonomidis, A, Spanakis, N, Poulou, A, Pournaras, S, Markou, F, Tsakris, A
• Format: Journal Article
• Language: English
• Published: 01.01.2007
• Subjects: Enterobacter cloacae
• ISSN: 1076-6294
• DOI: 10.1089/mdr.2007.768

Enterobacter cloacae strains are still infrequently resistant to carbapenems. A carbapenem-resistant clinical isolate of E. cloacae producing a plasmid-mediated metallo-b-lactamase (MBL), VIM-4, was recovered from a Greek hospitalized patient The bla sub(vim-4) gene was located in the variable array of a class 1 integron structure repeatedly detected among bla sub(vim-1)-bearing Gram-negative pathogens in Greece. The isolate possessed also on the same conjugative plasmid an extended-spectrum b-lactamase (ESBL), SHV-2a, which contributed to the b-lactam-resistant phenotype. This is the first report showing co-transfer of an ESBL with a VIM-type MBL. It suggests also that different VIM-type gene cassettes have been incorporated in a common integron structure, which seems indigenous of Gram-negative pathogens in our region.