51. Emergence of Enterobacter cloacae Complex Co-Producing IMP-10 and CTX-M, and Klebsiella pneumoniae Producing VIM-1 in Clinical Isolates in Japan
- Author
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Yuta Kamimura, Naohisa Matsunaga, Shinobu Ishigaki, Taiji Furukawa, Satoshi Nishida, and Yasuo Ono
- Subjects
0301 basic medicine ,Microbiology (medical) ,Klebsiella pneumoniae ,Enterobacter cloacae complex ,metallo-β-lactamase ,030106 microbiology ,Biology ,Microbiology ,Tertiary care ,03 medical and health sciences ,carbapenemase ,0302 clinical medicine ,Enterobacteriaceae ,multidrug resistance ,Virology ,Multiplex polymerase chain reaction ,polycyclic compounds ,030212 general & internal medicine ,lcsh:QH301-705.5 ,Klebsiella oxytoca ,biochemical phenomena, metabolism, and nutrition ,biology.organism_classification ,University hospital ,bacterial infections and mycoses ,Multiple drug resistance ,IMP-1 ,lcsh:Biology (General) ,bacteria ,VIM-1 - Abstract
Background: Carbapenemase-producing Enterobacteriaceae (CPE) are an emerging threat in healthcare settings worldwide. Objectives: We evaluated the presence of carbapenemase genes in CPE in a tertiary care university hospital in Tokyo, Japan. Methods: Carbapenem-resistant clinical isolates were collected in 2018 at Teikyo University Hospital (Tokyo, Japan). Bacterial species were identified using MALDI-TOF MS. Carbapenemase production was evaluated using a carbapenemase inactivation method. The presence of carbapenemase genes was confirmed by multiplex PCR and DNA sequencing. Results: Four CPE isolates were identified: two Enterobacter cloacae complex strains and Klebsiella oxytoca and Klebsiella pneumoniae strains. Three of the isolates (E. cloacae complex and K. oxytoca) were IMP-1-type producers, including IMP-10 in their produced metallo-β-lactamase, and are epidemic in East Japan. The IMP-10-producing E. cloacae complex strain also produced CTX-M ESBL. The other CPE isolate (K. pneumoniae) is a VIM-1 producer. VIM-1-producing K. pneumoniae is epidemic in Europe, especially in Greece. Accordingly, the VIM-1 producer was isolated from a patient with a medical history in Greece. Conclusions: This study revealed the emergence of E. cloacae complex co-producing IMP-1-type carbapenemase and CTX-M ESBL, and K. pneumoniae producing VIM-1 carbapenemase in clinical isolates in Japan. Metallo-β-lactamase was the most prevalent type of carbapenemase at Teikyo University Hospital, especially IMP-1-type carbapenemase. The detection of VIM-1-producing K. pneumoniae suggests that epidemic CPE from overseas can spread to countries with low CPE prevalence, such as Japan, highlighting the need for active surveillance.
- Published
- 2020