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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.

 Bum Sik Chin  ;  Sang Hoon Han  ;  Suk Hoon Choi  ;  Han Sung Lee  ;  Su Jin Jeong  ;  Hee Kyung Choi  ;  Jun Yong Choi  ;  Young Goo Song  ;  Chang Ki Kim  ;  Dongeun Yong  ;  Kyungwon Lee  ;  June Myung Kim 
 YONSEI MEDICAL JOURNAL, Vol.52(2) : 351-357, 2011 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Child ; Child, Preschool ; Electrophoresis, Gel, Pulsed-Field ; Female ; Gram-Negative Bacteria/drug effects ; Gram-Negative Bacteria/enzymology* ; Gram-Negative Bacteria/isolation & purification ; Gram-Negative Bacterial Infections/drug therapy ; Gram-Negative Bacterial Infections/enzymology ; Gram-Negative Bacterial Infections/microbiology ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Republic of Korea ; Sputum/microbiology* ; Urine/microbiology* ; beta-Lactam Resistance ; beta-Lactamases/metabolism*
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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1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, June Myung(김준명)
Kim, Chang Ki(김창기)
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Yong, Dong Eun(용동은) ORCID logo https://orcid.org/0000-0002-1225-8477
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
Lee, Han Sung(이한성)
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Chin, Bum Sik(진범식)
Choi, Suk Hoon(최석훈)
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
Choi, Hee Kyoung(최희경)
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
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