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Journal of Clinical Microbiology, September 2007, p. 2829-2834, Vol. 45, No. 9
0095-1137/07/$08.00+0     doi:10.1128/JCM.00997-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Outbreak of Pseudomonas aeruginosa Infections with PER-1 Extended-Spectrum ß-Lactamase in Warsaw, Poland: Further Evidence for an International Clonal Complex{triangledown}

Joanna Empel,1* Krzysztof Filczak,2 Agnieszka Mrówka,1 Waleria Hryniewicz,1 David M. Livermore,3 and Marek Gniadkowski1

National Medicines Institute, 00-725 Warsaw,1 Central Hospital of the Ministry of Interior and Administration, 02-507 Warsaw, Poland,2 Antibiotic Resistance Monitoring and Reference Laboratory, Health Protection Agency Centre for Infections, London NW9 5EQ, United Kingdom3

Received 14 May 2007/ Returned for modification 11 June 2007/ Accepted 6 July 2007

Forty-one Pseudomonas aeruginosa isolates with extended-spectrum ß-lactamases (ESBLs) from a hospital in Warsaw, Poland, were analyzed. Thirty-seven isolates from several wards were collected over 9 months in 2003 and 2004. The isolates were recovered from patients with multiple types of infections, mostly respiratory tract and postoperative wound infections. All 41 isolates produced the PER-1 ESBL, originally observed in Turkey but recently also identified in several countries in Europe and the Far East. The blaPER-1 gene resided within the Tn1213 composite transposon, which was chromosomally located. Pulsed-field gel electrophoresis and multilocus sequence typing (MLST) revealed the presence of three separate clones among the isolates. Two of these, corresponding to sequence types (STs) ST244 and ST235, were responsible for parallel outbreaks. Apart from PER-1, all the isolates produced OXA-2 oxacillinase. ST235 isolates additionally expressed a novel enzyme, OXA-74, differing by one amino acid from the OXA-17 ESBL identified originally in PER-1- and OXA-2-positive P. aeruginosa isolates from Ankara, Turkey, in 1992. These earlier Ankara isolates with PER-1, OXA-2, and OXA-17 were also classified into ST235, which is a single-locus variant of two other STs, ST227 and ST230. ST227, ST230, and ST235 all correspond to the recently described clonal complex BG11, which seems to be internationally distributed, having spread in Turkey, Greece, Italy, Hungary, Poland, Sweden, and much of Russia. It is associated with various ß-lactamases, including PER-1 and VIM metalloenzymes. This work further demonstrates the value of MLST of P. aeruginosa.

* Corresponding author. Mailing address: National Medicines Institute, ul. Chelmska 30/34, 00-725 Warsaw, Poland. Phone: (48) 22-851 43 88. Fax: (48) 22-841 29 49. E-mail: jempel{at}cls.edu.pl

{triangledown} Published ahead of print on 18 July 2007.

Journal of Clinical Microbiology, September 2007, p. 2829-2834, Vol. 45, No. 9
0095-1137/07/$08.00+0     doi:10.1128/JCM.00997-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.



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