The characteristics of metallo-β-lactamase-producing gram-negative bacilli isolated from sputum and urine

A single center experience in Korea

Bum Sik Chin, Sang Hoon Han, Suk Hoon Choi, Han Sung Lee, Su Jin Jeong, Hee Kyung Choi, JunYong Choi, Young Goo Song, Chang Ki Kim, DongEun Yong, Kyungwon Lee, June Myung Kim

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Metallo-β-lactamase (MBL) production usually results in high-level resistance to most β-lactams, and a rapid spread of MBL producing major gram-negative pathogens is a matter of particular concern worldwide. However, clinical data are scarce and most studies compared MBL producer (MP) with MBL non-producer (MNP) strains which included carbapenem susceptible isolates. Therefore, we collected clinical data of patients in whom imipenem-nonsusceptible Pseudomonas aeruginosa (PA) and Acinetobacter baumannii (AB) were isolated from sputum or urine, and investigated MBL production and the risk factors related with MBL acquisition. The antimicrobial susceptibility patterns were also compared between MPs and imipenem-nonsusceptible MNPs (INMNP). Among the 176 imipenem-nonsusceptible isolates, 12 MPs (6.8%) were identified. There was no identifiable risk factor that contributed to the acquisition of MPs when compared to INMNPs, and case-fatalities were not different between the two groups. The percentage of susceptible isolates was higher among MPs for piperacilin/tazobactam and fluoroquinolones while that of ceftazidime was higher in INMNPs (p < 0.05). As regards to aztreonam, which has been known to be a uniquely stable β-lactam against MBLs, susceptibility was preserved in only two isolates (16.7%) among MPs, and was not higher than that of INMNPs (23.2%). In conclusion, the contribution of MBLs to imipenem non-susceptibility in PA/ABs isolated from sputum and urine was relatively limited, and there was no significant risk factor associated with acquisition of MPs compared with INMNPs. However, limited susceptibility to aztreonam implies that MPs may hold additional resistance mechanisms, such as extended spectrum β-lactamases, AmpC β-lactamases, or other non-enzymatic mechanisms.

Original languageEnglish
Pages (from-to)351-357
Number of pages7
JournalYonsei medical journal
Volume52
Issue number2
DOIs
Publication statusPublished - 2011 Mar 1

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Imipenem
Korea
Sputum
Bacillus
Urine
Aztreonam
Lactams
Pseudomonas aeruginosa
Acinetobacter baumannii
Carbapenems
Ceftazidime
Fluoroquinolones

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Chin, Bum Sik ; Han, Sang Hoon ; Choi, Suk Hoon ; Lee, Han Sung ; Jeong, Su Jin ; Choi, Hee Kyung ; Choi, JunYong ; Song, Young Goo ; Kim, Chang Ki ; Yong, DongEun ; Lee, Kyungwon ; Kim, June Myung. / The characteristics of metallo-β-lactamase-producing gram-negative bacilli isolated from sputum and urine : A single center experience in Korea. In: Yonsei medical journal. 2011 ; Vol. 52, No. 2. pp. 351-357.
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abstract = "Metallo-β-lactamase (MBL) production usually results in high-level resistance to most β-lactams, and a rapid spread of MBL producing major gram-negative pathogens is a matter of particular concern worldwide. However, clinical data are scarce and most studies compared MBL producer (MP) with MBL non-producer (MNP) strains which included carbapenem susceptible isolates. Therefore, we collected clinical data of patients in whom imipenem-nonsusceptible Pseudomonas aeruginosa (PA) and Acinetobacter baumannii (AB) were isolated from sputum or urine, and investigated MBL production and the risk factors related with MBL acquisition. The antimicrobial susceptibility patterns were also compared between MPs and imipenem-nonsusceptible MNPs (INMNP). Among the 176 imipenem-nonsusceptible isolates, 12 MPs (6.8{\%}) were identified. There was no identifiable risk factor that contributed to the acquisition of MPs when compared to INMNPs, and case-fatalities were not different between the two groups. The percentage of susceptible isolates was higher among MPs for piperacilin/tazobactam and fluoroquinolones while that of ceftazidime was higher in INMNPs (p < 0.05). As regards to aztreonam, which has been known to be a uniquely stable β-lactam against MBLs, susceptibility was preserved in only two isolates (16.7{\%}) among MPs, and was not higher than that of INMNPs (23.2{\%}). In conclusion, the contribution of MBLs to imipenem non-susceptibility in PA/ABs isolated from sputum and urine was relatively limited, and there was no significant risk factor associated with acquisition of MPs compared with INMNPs. However, limited susceptibility to aztreonam implies that MPs may hold additional resistance mechanisms, such as extended spectrum β-lactamases, AmpC β-lactamases, or other non-enzymatic mechanisms.",
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The characteristics of metallo-β-lactamase-producing gram-negative bacilli isolated from sputum and urine : A single center experience in Korea. / Chin, Bum Sik; Han, Sang Hoon; Choi, Suk Hoon; Lee, Han Sung; Jeong, Su Jin; Choi, Hee Kyung; Choi, JunYong; Song, Young Goo; Kim, Chang Ki; Yong, DongEun; Lee, Kyungwon; Kim, June Myung.

In: Yonsei medical journal, Vol. 52, No. 2, 01.03.2011, p. 351-357.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The characteristics of metallo-β-lactamase-producing gram-negative bacilli isolated from sputum and urine

T2 - A single center experience in Korea

AU - Chin, Bum Sik

AU - Han, Sang Hoon

AU - Choi, Suk Hoon

AU - Lee, Han Sung

AU - Jeong, Su Jin

AU - Choi, Hee Kyung

AU - Choi, JunYong

AU - Song, Young Goo

AU - Kim, Chang Ki

AU - Yong, DongEun

AU - Lee, Kyungwon

AU - Kim, June Myung

PY - 2011/3/1

Y1 - 2011/3/1

N2 - Metallo-β-lactamase (MBL) production usually results in high-level resistance to most β-lactams, and a rapid spread of MBL producing major gram-negative pathogens is a matter of particular concern worldwide. However, clinical data are scarce and most studies compared MBL producer (MP) with MBL non-producer (MNP) strains which included carbapenem susceptible isolates. Therefore, we collected clinical data of patients in whom imipenem-nonsusceptible Pseudomonas aeruginosa (PA) and Acinetobacter baumannii (AB) were isolated from sputum or urine, and investigated MBL production and the risk factors related with MBL acquisition. The antimicrobial susceptibility patterns were also compared between MPs and imipenem-nonsusceptible MNPs (INMNP). Among the 176 imipenem-nonsusceptible isolates, 12 MPs (6.8%) were identified. There was no identifiable risk factor that contributed to the acquisition of MPs when compared to INMNPs, and case-fatalities were not different between the two groups. The percentage of susceptible isolates was higher among MPs for piperacilin/tazobactam and fluoroquinolones while that of ceftazidime was higher in INMNPs (p < 0.05). As regards to aztreonam, which has been known to be a uniquely stable β-lactam against MBLs, susceptibility was preserved in only two isolates (16.7%) among MPs, and was not higher than that of INMNPs (23.2%). In conclusion, the contribution of MBLs to imipenem non-susceptibility in PA/ABs isolated from sputum and urine was relatively limited, and there was no significant risk factor associated with acquisition of MPs compared with INMNPs. However, limited susceptibility to aztreonam implies that MPs may hold additional resistance mechanisms, such as extended spectrum β-lactamases, AmpC β-lactamases, or other non-enzymatic mechanisms.

AB - Metallo-β-lactamase (MBL) production usually results in high-level resistance to most β-lactams, and a rapid spread of MBL producing major gram-negative pathogens is a matter of particular concern worldwide. However, clinical data are scarce and most studies compared MBL producer (MP) with MBL non-producer (MNP) strains which included carbapenem susceptible isolates. Therefore, we collected clinical data of patients in whom imipenem-nonsusceptible Pseudomonas aeruginosa (PA) and Acinetobacter baumannii (AB) were isolated from sputum or urine, and investigated MBL production and the risk factors related with MBL acquisition. The antimicrobial susceptibility patterns were also compared between MPs and imipenem-nonsusceptible MNPs (INMNP). Among the 176 imipenem-nonsusceptible isolates, 12 MPs (6.8%) were identified. There was no identifiable risk factor that contributed to the acquisition of MPs when compared to INMNPs, and case-fatalities were not different between the two groups. The percentage of susceptible isolates was higher among MPs for piperacilin/tazobactam and fluoroquinolones while that of ceftazidime was higher in INMNPs (p < 0.05). As regards to aztreonam, which has been known to be a uniquely stable β-lactam against MBLs, susceptibility was preserved in only two isolates (16.7%) among MPs, and was not higher than that of INMNPs (23.2%). In conclusion, the contribution of MBLs to imipenem non-susceptibility in PA/ABs isolated from sputum and urine was relatively limited, and there was no significant risk factor associated with acquisition of MPs compared with INMNPs. However, limited susceptibility to aztreonam implies that MPs may hold additional resistance mechanisms, such as extended spectrum β-lactamases, AmpC β-lactamases, or other non-enzymatic mechanisms.

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