Emergence of carbapenem-resistant Enterobacter cloacae carrying VIM-4 metallo-β-lactamase and SHV-2a extended-spectrum β-lactamase in a conjugative plasmid

Emergence of carbapenem-resistant Enterobacter cloacae carrying VIM-4 metallo-β-lactamase and SHV-2a extended-spectrum β-lactamase in a conjugative plasmid

Enterobacter cloacae strains are still infrequently resistant to carbapenems. A carbapenem-resistant clinical isolate of E. cloacae producing a plasmid-mediated metallo-β-lactamase (MBL), VIM-4, was recovered from a Greek hospitalized patient. The blaVIM-4 gene was located in the variable array of a class 1 integron structure repeatedly detected among blaVIM-1-bearing Gram-negative pathogens in Greece. The isolate possessed also on the same conjugative plasmid an extended-spectrum β-lactamase (ESBL), SHV-2a, which contributed to the β-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. © 2007 Mary Ann Liebert, Inc.

Ikonomidis, A. Spanakis, N. Poulou, A. Pournaras, S. Markou, F. Tsakris, A.

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