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Epidemiology

Multifocal Detection of Multidrug-Resistant Pseudomonas aeruginosa Producing the PER-1 Extended-Spectrum β-Lactamase in Northern Italy

Laura Pagani, Elisabetta Mantengoli, Roberta Migliavacca, Elisabetta Nucleo, Simona Pollini, Melissa Spalla, Rossana Daturi, Egidio Romero, Gian Maria Rossolini
Laura Pagani
1Dipartimento di Scienze Morfologiche, Eidologiche e Cliniche, Sezione di Microbiologia, Università di Pavia
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Elisabetta Mantengoli
2Dipartimento di Biologia Molecolare, Sezione di Microbiologia, Università di Siena, Siena, Italy
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Roberta Migliavacca
1Dipartimento di Scienze Morfologiche, Eidologiche e Cliniche, Sezione di Microbiologia, Università di Pavia
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Elisabetta Nucleo
1Dipartimento di Scienze Morfologiche, Eidologiche e Cliniche, Sezione di Microbiologia, Università di Pavia
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Simona Pollini
2Dipartimento di Biologia Molecolare, Sezione di Microbiologia, Università di Siena, Siena, Italy
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Melissa Spalla
3Servizio di Analisi Microbiologiche IRCCSS Matteo, Pavia
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Rossana Daturi
3Servizio di Analisi Microbiologiche IRCCSS Matteo, Pavia
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Egidio Romero
1Dipartimento di Scienze Morfologiche, Eidologiche e Cliniche, Sezione di Microbiologia, Università di Pavia
3Servizio di Analisi Microbiologiche IRCCSS Matteo, Pavia
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Gian Maria Rossolini
2Dipartimento di Biologia Molecolare, Sezione di Microbiologia, Università di Siena, Siena, Italy
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  • For correspondence: rossolini@unisi.it
DOI: 10.1128/JCM.42.6.2523-2529.2004
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ABSTRACT

Forty-four nonreplicate clinical isolates of Pseudomonas aeruginosa that were resistant to extended-spectrum cephalosporins (ceftazidime and cefepime) and aztreonam, that putatively produced an acquired extended- spectrum β-lactamase (ESBL), according to the results of a double-disk synergy test, and that had been involved in nosocomial outbreaks were obtained from six different hospitals in northern Italy and screened for the presence of blaPER ESBL determinants. Twenty isolates, associated with nine independent outbreaks that occurred in five hospitals in the Milan area and its surroundings during 1995-2000, were found to carry an acquired blaPER-1 gene. PER-1 producers representative of the nine outbreaks exhibited a multidrug resistance (MDR) phenotype, including resistance to extended-spectrum cephalosporins, aztreonam, meropenem, aminoglycosides, and in most cases, imipenem and ciprofloxacin. An analysis of macrorestriction profiles of their genomic DNAs by pulsed-field gel electrophoresis revealed an overall clonal diversity of the PER-1 producers, although interhospital clonal spread was also observed. The blaPER-1 gene was not transferable and appeared to be chromosomally located. An analysis of the EcoRI and EcoRV restriction fragment length polymorphisms of the blaPER-1 locus revealed identical patterns for all isolates, and the characterization of a 1.9-kb region containing blaPER-1 revealed a conserved structure in representatives of the various clonal lineages. The present findings indicate that MDR P. aeruginosa clones producing the PER-1 ESBL are endemic to this area of northern Italy, where they have been circulating since the mid-1990s and have been associated with several nosocomial outbreaks.

  • Copyright © 2004 American Society for Microbiology
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Multifocal Detection of Multidrug-Resistant Pseudomonas aeruginosa Producing the PER-1 Extended-Spectrum β-Lactamase in Northern Italy
Laura Pagani, Elisabetta Mantengoli, Roberta Migliavacca, Elisabetta Nucleo, Simona Pollini, Melissa Spalla, Rossana Daturi, Egidio Romero, Gian Maria Rossolini
Journal of Clinical Microbiology Jun 2004, 42 (6) 2523-2529; DOI: 10.1128/JCM.42.6.2523-2529.2004

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Multifocal Detection of Multidrug-Resistant Pseudomonas aeruginosa Producing the PER-1 Extended-Spectrum β-Lactamase in Northern Italy
Laura Pagani, Elisabetta Mantengoli, Roberta Migliavacca, Elisabetta Nucleo, Simona Pollini, Melissa Spalla, Rossana Daturi, Egidio Romero, Gian Maria Rossolini
Journal of Clinical Microbiology Jun 2004, 42 (6) 2523-2529; DOI: 10.1128/JCM.42.6.2523-2529.2004
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KEYWORDS

Drug Resistance, Multiple, Bacterial
Pseudomonas aeruginosa
beta-lactamases

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