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Yoon EJ, Jeong SH. Mobile Carbapenemase Genes in Pseudomonas aeruginosa. Front Microbiol 2021; 12:614058. [PMID: 33679638 PMCID: PMC7930500 DOI: 10.3389/fmicb.2021.614058] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/04/2021] [Indexed: 02/06/2023] Open
Abstract
Carbapenem-resistant Pseudomonas aeruginosa is one of the major concerns in clinical settings impelling a great challenge to antimicrobial therapy for patients with infections caused by the pathogen. While membrane permeability, together with derepression of the intrinsic beta-lactamase gene, is the global prevailing mechanism of carbapenem resistance in P. aeruginosa, the acquired genes for carbapenemases need special attention because horizontal gene transfer through mobile genetic elements, such as integrons, transposons, plasmids, and integrative and conjugative elements, could accelerate the dissemination of the carbapenem-resistant P. aeruginosa. This review aimed to illustrate epidemiologically the carbapenem resistance in P. aeruginosa, including the resistance rates worldwide and the carbapenemase-encoding genes along with the mobile genetic elements responsible for the horizontal dissemination of the drug resistance determinants. Moreover, the modular mobile elements including the carbapenemase-encoding gene, also known as the P. aeruginosa resistance islands, are scrutinized mostly for their structures.
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Affiliation(s)
- Eun-Jeong Yoon
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea
| | - Seok Hoon Jeong
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea
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Çekin ZK, Dabos L, Malkoçoğlu G, Fortineau N, Bayraktar B, Iorga BI, Naas T, Aktaş E. Carbapenemase -producing Pseudomonas aeruginosa isolates from Turkey: first report of P. aeruginosa high-risk clones with VIM-5- and IMP-7-type carbapenemases in a tertiary hospital. Diagn Microbiol Infect Dis 2020; 99:115174. [PMID: 32980808 DOI: 10.1016/j.diagmicrobio.2020.115174] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/29/2020] [Accepted: 08/05/2020] [Indexed: 02/08/2023]
Abstract
We investigated the presence of carbapenemases in carbapenem-resistant Pseudomonas aeruginosa isolates, which were collected over a 14-month period in a Turkish hospital, with in-depth molecular characterization of carbapenemase-producing isolates. Among 45 study isolates, 2 isolates were identified as carbapenemase producers by both Carba NP and Carbapenem Inactivation Method tests, and only 1 of them gave a positive result in polymerase chain reaction tests for a carbapenemase gene (blaVIM). Whole genome sequencing of the 2 isolates revealed the presence of blaVIM-5 gene in an ST308 isolate, while the other one expressed IMP-7 in an ST357 isolate; both STs are considered high-risk clones. The 2 carbapenemase-producing isolates were multidrug resistant, as they harbored other resistance determinants, including a variant of the recently described plasmid-encoded fluoroquinolone resistance determinant crpP gene, crpP-2. We report for the first time P. aeruginosa high-risk clones carrying VIM-5- and IMP-7-type carbapenemases with multiple resistance determinants in Turkey.
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Affiliation(s)
- Zuhal Kalaycı Çekin
- Şişli Hamidiye Etfal Training and Research Hospital, Clinical Microbiology Laboratory, Istanbul, Turkey
| | - Laura Dabos
- UMR1184, Team RESIST, INSERM, University Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France; Joint research Unit EERA « Evolution and Ecology of Resistance to Antibiotics », Institut Pasteur-APHP-University Paris Sud, Paris, France
| | | | - Nicolas Fortineau
- UMR1184, Team RESIST, INSERM, University Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France; Joint research Unit EERA « Evolution and Ecology of Resistance to Antibiotics », Institut Pasteur-APHP-University Paris Sud, Paris, France; Department of Bacteriology-Hygiene, Bicêtre Hospital, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France; French National Reference Center for Antibiotic Resistance, Le Kremlin-Bicêtre, France
| | - Banu Bayraktar
- Şişli Hamidiye Etfal Training and Research Hospital, Clinical Microbiology Laboratory, Istanbul, Turkey
| | - Bogdan I Iorga
- Université Paris-Saclay, CNRS, Institut de Chimie des Substances Naturelles, Gif-sur-Yvette, France
| | - Thierry Naas
- UMR1184, Team RESIST, INSERM, University Paris-Saclay, Faculty of Medicine, Le Kremlin-Bicêtre, France; Joint research Unit EERA « Evolution and Ecology of Resistance to Antibiotics », Institut Pasteur-APHP-University Paris Sud, Paris, France; Department of Bacteriology-Hygiene, Bicêtre Hospital, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France; French National Reference Center for Antibiotic Resistance, Le Kremlin-Bicêtre, France.
| | - Elif Aktaş
- Şişli Hamidiye Etfal Training and Research Hospital, Clinical Microbiology Laboratory, Istanbul, Turkey.
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Osawa K, Shigemura K, Kitagawa K, Fukuda T, Takasaka A, Wakabayashi S, Sato K, Yamamichi F, Shirakawa T, Fujisawa M. Molecular characteristics of carbapenem-resistant Pseudomonas aeruginosa isolated from urine in Hyogo, Japan. Int J Urol 2018; 26:127-133. [PMID: 30308701 DOI: 10.1111/iju.13818] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 08/27/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To investigate the molecular characteristics and epidemiology of metallo-β-lactamase-producing Pseudomonas aeruginosa from urine of urinary tract infection patients in Hyogo Prefecture, Japan. METHODS Carbapenem-resistant P. aeruginosa isolated from the urine of 21 urinary tract infection patients in three general hospitals in Hyogo Prefecture (Japan) were collected between 2007 and 2014. Their antibiotic susceptibilities, metallo-β-lactamase screening test, metallo-β-lactamase gene sequencing, multilocus sequence typing and repetitive-sequence-based polymerase chain reaction were determined for epidemiological analyses to investigate the genetic characteristics. RESULTS Out of 21 isolates, 13 (61.9%) were positive for metallo-β-lactamase. There were 11 (52.4%) isolates with IMP-1 in them, one (4.5%) isolate with IMP-7 and one (4.5%) isolate with VIM-1. Metallo-β-lactamase-positive isolates were mainly identified as ST235, and metallo-β-lactamase-negative isolates were STs 357, 277, 234, 439 and 639. Repetitive-sequence-based polymerase chain reaction showed metallo-β-lactamase-positive isolates were grouped in eight clusters, and ST235 isolates with IMP-1 from three hospitals belonging to the identical group I, the other ST235 isolates with IMP-7 and VIM-1 were from two hospitals belonging to group II. CONCLUSIONS Metallo-β-lactamase-positive P. aeruginosa of ST235 isolates with IPM-1 were mainly identified from the urine of urinary tract infection patients in Hyogo, Japan. A ST235 isolate with VIM-1 was found for the first time. Further investigation is necessary to follow the spread of metallo-β-lactamase-positive isolates.
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Affiliation(s)
- Kayo Osawa
- Department of Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Katsumi Shigemura
- Division of Urology, Department of Organ Therapeutics, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Infectious Diseases, Department of International Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Koichi Kitagawa
- Division of Infectious Diseases, Department of International Health, Kobe University Graduate School of Health Sciences, Kobe, Japan.,Division of Translational Research for Biologics, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Advanced Medical Science, Kobe University Graduate School of Science, Technology and Innovation, Kobe, Japan
| | - Teruo Fukuda
- Division of Urology, Department of Organ Therapeutics, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ayaka Takasaka
- Department of Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Sakie Wakabayashi
- Department of Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Kanako Sato
- Department of Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | | | - Toshiro Shirakawa
- Division of Urology, Department of Organ Therapeutics, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Infectious Diseases, Department of International Health, Kobe University Graduate School of Health Sciences, Kobe, Japan.,Division of Translational Research for Biologics, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Advanced Medical Science, Kobe University Graduate School of Science, Technology and Innovation, Kobe, Japan
| | - Masato Fujisawa
- Division of Urology, Department of Organ Therapeutics, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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Nishida S, Ishigaki S, Asahara M, Furukawa T, Ono Y. Emergence of multiple carbapenemase-producing Gram-negative species, colistin-resistant KPC-2-producing Klebsiella pneumoniae ST11, IMP-7-producing Pseudomonas aeruginosa ST357, and OXA-23-producing Acinetobacter baumannii ST1050, in a single patient. Int J Antimicrob Agents 2018; 52:512-514. [DOI: 10.1016/j.ijantimicag.2018.06.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/23/2018] [Accepted: 06/30/2018] [Indexed: 11/30/2022]
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El-Shouny WA, Ali SS, Sun J, Samy SM, Ali A. Drug resistance profile and molecular characterization of extended spectrum beta-lactamase (ESβL)-producing Pseudomonas aeruginosa isolated from burn wound infections. Essential oils and their potential for utilization. Microb Pathog 2018; 116:301-312. [PMID: 29407236 DOI: 10.1016/j.micpath.2018.02.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/14/2018] [Accepted: 02/02/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Pseudomonas aeruginosa producing extended spectrum β-lactamase (ESβL) enzyme had the ability for antimicrobial resistance mechanisms and its multidrug-resistant (MDR) phenotype, has been increasingly reported as a major clinical concern worldwide. The aim of this study was to (i) characterize ESβL-producing MDR P. aeruginosa isolated from burn wound infections phenotypically and molecularly, (ii) evaluate the antibacterial activity of some essential oils (EOs) against selected ESβL-producing drug resistant P. aeruginosa and (iii) characterize a promising EO. METHODS Identification and antibiotic susceptibility tests were performed for all isolates. ESβL production was detected phenotypically by an initial screening test (IST) and a phenotypic confirmatory test (PCT). Additionally, ESβL-producing isolates were also characterized molecularly. The antibacterial activity was detected using a disc diffusion method. Mechanisms of antibacterial action, the fatty acid profile, and functional groups characterization of the promising EO were analyzed using scanning and transmission electron microscopy (SEM & TEM), gas chromatography-mass spectrometry (GC-MS), and Fourier transform infrared (FTIR) spectroscopy, respectively. RESULTS A total of 50 non duplicated P. aeruginosa isolates from the wound samples of burn patients were identified. Of these, MDR and pan-drug resistance (PDR) showed a high prevalence in 38 (76%) isolates obtained from 10 clusters, while 21 (42%) were identified as ESβL-producing MDR or PDR P. aeruginosa isolates. Phenotypic detection of ESβL production showed that 20% were considered positive ESβL-producing P. aeruginosa using the IST, and were increased to 56% by the PCT. The most prevalent ESβL-encoding gene was blaOXA-2 (60.7%), followed by blaIMP-7 (53.6%) and blaOXA-50 (42.8%). Ginger oil is the most efficient antibacterial agent and its antibacterial action mechanism is attributed to the morphological changes in bacterial cells. The oil characterization revealed that 9,12-Octadecadienoic acid methyl ester is the major fatty acid (50.49%) identified. CONCLUSION The high incidence of drug-resistance in ESβL-producing P. aeruginosa isolated from burn wounds is alarming. As proven in vitro, EOs may represent promising natural alternatives against ESβL-producing PDR or MDR P. aeruginosa isolates.
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Affiliation(s)
- Wagih A El-Shouny
- Botany Department, Faculty of Science, Tanta University, 31527 Tanta, Egypt
| | - Sameh S Ali
- Biofuels Institute, School of the Environment and Safety Engineering, Jiangsu University, 212013 Zhenjiang, China; Botany Department, Faculty of Science, Tanta University, 31527 Tanta, Egypt
| | - Jianzhong Sun
- Biofuels Institute, School of the Environment and Safety Engineering, Jiangsu University, 212013 Zhenjiang, China.
| | - Sara M Samy
- Botany Department, Faculty of Science, Tanta University, 31527 Tanta, Egypt
| | - Asmaa Ali
- Abbasia Chest Hospital, Ministry of Health, 11765 Cairo, Egypt
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Draft Genome Sequence of an IMP-7-Producing Pseudomonas aeruginosa Bloodstream Infection Isolate from Australia. GENOME ANNOUNCEMENTS 2017; 5:5/27/e00596-17. [PMID: 28684579 PMCID: PMC5502860 DOI: 10.1128/genomea.00596-17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
IMP-7 is one of the two IMP-type carbapenemases that in Pseudomonas aeruginosa are not limited to a geographic area, but it has not been previously reported in the Australian setting. We report here the draft genome sequence of an Australian P. aeruginosa bloodstream infection isolate that contains IMP-7.
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Hong DJ, Bae IK, Jang IH, Jeong SH, Kang HK, Lee K. Epidemiology and Characteristics of Metallo-β-Lactamase-Producing Pseudomonas aeruginosa. Infect Chemother 2015; 47:81-97. [PMID: 26157586 PMCID: PMC4495280 DOI: 10.3947/ic.2015.47.2.81] [Citation(s) in RCA: 160] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Indexed: 12/18/2022] Open
Abstract
Metallo-β-lactamase-producing Pseudomonas aeruginosa (MPPA) is an important nosocomial pathogen that shows resistance to all β-lactam antibiotics except monobactams. There are various types of metallo-β-lactamases (MBLs) in carbapenem-resistant P. aeruginosa including Imipenemase (IMP), Verona integron-encoded metallo-β-lactamase (VIM), Sao Paulo metallo-β-lactamase (SPM), Germany imipenemase (GIM), New Delhi metallo-β-lactamase (NDM), Florence imipenemase (FIM). Each MBL gene is located on specific genetic elements including integrons, transposons, plasmids, or on the chromosome, in which they carry genes encoding determinants of resistance to carbapenems and other antibiotics, conferring multidrug resistance to P. aeruginosa. In addition, these genetic elements are transferable to other Gram-negative species, increasing the antimicrobial resistance rate and complicating the treatment of infected patients. Therefore, it is essential to understand the epidemiology, resistance mechanism, and molecular characteristics of MPPA for infection control and prevention of a possible global health crisis. Here, we highlight the characteristics of MPPA.
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Affiliation(s)
- Duck Jin Hong
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Il Kwon Bae
- Department of Dental Hygiene, Silla University, Busan, Korea
| | - In-Ho Jang
- Department of Biomedical Laboratory Science, College of Health Sciences, Sangji University, Wonju, Korea
| | - Seok Hoon Jeong
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun-Kyung Kang
- Department of Dental Hygiene, Silla University, Busan, Korea
| | - Kyungwon Lee
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
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Potron A, Poirel L, Nordmann P. Emerging broad-spectrum resistance in Pseudomonas aeruginosa and Acinetobacter baumannii: Mechanisms and epidemiology. Int J Antimicrob Agents 2015; 45:568-85. [PMID: 25857949 DOI: 10.1016/j.ijantimicag.2015.03.001] [Citation(s) in RCA: 451] [Impact Index Per Article: 50.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 03/05/2015] [Indexed: 02/07/2023]
Abstract
Multidrug resistance is quite common among non-fermenting Gram-negative rods, in particular among clinically relevant species including Pseudomonas aeruginosa and Acinetobacter baumannii. These bacterial species, which are mainly nosocomial pathogens, possess a diversity of resistance mechanisms that may lead to multidrug or even pandrug resistance. Extended-spectrum β-lactamases (ESBLs) conferring resistance to broad-spectrum cephalosporins, carbapenemases conferring resistance to carbapenems, and 16S rRNA methylases conferring resistance to all clinically relevant aminoglycosides are the most important causes of concern. Concomitant resistance to fluoroquinolones, polymyxins (colistin) and tigecycline may lead to pandrug resistance. The most important mechanisms of resistance in P. aeruginosa and A. baumannii and their most recent dissemination worldwide are detailed here.
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Affiliation(s)
- Anaïs Potron
- Laboratoire de Bactériologie, Faculté de Médecine-Pharmacie, Centre Hospitalier Régional Universitaire, Université de Franche-Comté, Besançon, France
| | - Laurent Poirel
- Emerging Antibiotic Resistance Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Fribourg, Switzerland.
| | - Patrice Nordmann
- Emerging Antibiotic Resistance Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Fribourg, Switzerland; HFR - Hôpital Cantonal de Fribourg, Fribourg, Switzerland
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IMP-43 and IMP-44 metallo-β-lactamases with increased carbapenemase activities in multidrug-resistant Pseudomonas aeruginosa. Antimicrob Agents Chemother 2013; 57:4427-32. [PMID: 23836174 DOI: 10.1128/aac.00716-13] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Two novel IMP-type metallo-β-lactamase variants, IMP-43 and IMP-44, were identified in multidrug-resistant Pseudomonas aeruginosa isolates obtained in medical settings in Japan. Analysis of their predicted amino acid sequences revealed that IMP-43 had an amino acid substitution (Val67Phe) compared with IMP-7 and that IMP-44 had two substitutions (Val67Phe and Phe87Ser) compared with IMP-11. The amino acid residue at position 67 is located at the end of a loop close to the active site, consisting of residues 60 to 66 in IMP-1, and the amino acid residue at position 87 forms a hydrophobic patch close to the active site with other amino acids. An Escherichia coli strain expressing blaIMP-43 was more resistant to doripenem and meropenem but not to imipenem than one expressing blaIMP-7. An E. coli strain expressing blaIMP-44 was more resistant to doripenem, imipenem and meropenem than one expressing blaIMP-11. IMP-43 had more efficient catalytic activities against all three carbapenems than IMP-7, indicating that the Val67Phe substitution contributed to increased catalytic activities against carbapenems. IMP-44 had more efficient catalytic activities against all carbapenems tested than IMP-11, as well as increased activities compared with IMP-43, indicating that both the Val67Phe and Phe87Ser substitutions contributed to increased catalytic activities against carbapenems.
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Cornaglia G, Giamarellou H, Rossolini GM. Metallo-β-lactamases: a last frontier for β-lactams? THE LANCET. INFECTIOUS DISEASES 2011; 11:381-93. [PMID: 21530894 DOI: 10.1016/s1473-3099(11)70056-1] [Citation(s) in RCA: 477] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Metallo-β-lactamases are resistance determinants of increasing clinical relevance in Gram-negative bacteria. Because of their broad range, potent carbapenemase activity and resistance to inhibitors, these enzymes can confer resistance to almost all β-lactams. Since the 1990s, several metallo-β-lactamases encoded by mobile DNA have emerged in important Gram-negative pathogens (ie, in Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter baumannii). Some of these enzymes (eg, VIM-1 and NDM-1) have been involved in the recent crisis resulting from the international dissemination of carbapenem-resistant Klebsiella pneumoniae and other enterobacteria. Although substantial knowledge about the molecular biology and genetics of metallo-β-lactamases is available, epidemiological data are inconsistent and clinical experience is still lacking; therefore, several unsolved or debatable issues remain about the management of infections caused by producers of metallo-β-lactamase. The spread of metallo-β-lactamases presents a major challenge both for treatment of individual patients and for policies of infection control, exposing the substantial unpreparedness of public health structures in facing up to this emergency.
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Affiliation(s)
- Giuseppe Cornaglia
- Department of Pathology and Diagnostics, University of Verona, Verona, Italy.
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Regional spread of Pseudomonas aeruginosa ST357 producing IMP-7 metallo-β-lactamase in Central Europe. J Clin Microbiol 2010; 49:474-5. [PMID: 20980582 DOI: 10.1128/jcm.00684-10] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Khosravi Y, Tee Tay S, Vadivelu J. Metallo-β-lactamase–producing imipenem-resistant Pseudomonas aeruginosa clinical isolates in a university teaching hospital in Malaysia: detection of IMP-7 and first identification of IMP-4, VIM-2, and VIM-11. Diagn Microbiol Infect Dis 2010; 67:294-6. [DOI: 10.1016/j.diagmicrobio.2010.02.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Revised: 01/09/2010] [Accepted: 02/12/2010] [Indexed: 11/25/2022]
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