Providencia stuartii Isolates from Greece: Co-Carriage of Cephalosporin (blaSHV-5, blaVEB-1), Carbapenem (blaVIM-1), and Aminoglycoside (rmtB) Resistance Determinants by a Multidrug-Resistant Outbreak Clone

Olga Oikonomou; Apostolos Liakopoulos; Lynette M Phee; Jonathan W. Betts; Dik Mevius; David W Wareham

doi:10.1089/mdr.2015.0215

Providencia stuartii Isolates from Greece: Co-Carriage of Cephalosporin (blaSHV-5, blaVEB-1), Carbapenem (blaVIM-1), and Aminoglycoside (rmtB) Resistance Determinants by a Multidrug-Resistant Outbreak Clone

Olga Oikonomou
, Apostolos Liakopoulos
, Lynette M Phee
, Jonathan W. Betts
, Dik Mevius
, David W Wareham^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Providencia stuartii has emerged as an important nosocomial pathogen. We describe an outbreak due to a multidrug-resistant strain over a 4-month period in a critical care unit in Athens. Molecular typing revealed each of the isolates to be clonally related with coresistance to cephalosporins, carbapenems, aminoglycosides, and quinolones. Each isolate contained a 220-kb multi-replicon (IncA/C and IncR) conjugative plasmid encoding TEM-1, SHV-5, VEB-1, and VIM-1 β-lactamases and the 16S rDNA methylase RmtB. Antimicrobial therapy was unsuccessful in 3 of 6 cases, and resistance was readily transmissible to susceptible strains of Escherichia coli by transformation and conjugation. This highlights the clinical importance of P. stuartii and its ability to disseminate critical resistance determinants to other bacterial pathogens.

Original language	English
Pages (from-to)	379-86
Number of pages	8
Journal	Microbial drug resistance (Larchmont, N.Y.)
Volume	22
Issue number	5
DOIs	https://doi.org/10.1089/mdr.2015.0215
Publication status	Published - Jul 2016
Externally published	Yes

Keywords

Adult
Aged
Aminoglycosides/pharmacology
Anti-Bacterial Agents/pharmacology
Bacterial Proteins/genetics
Carbapenems/pharmacology
Cephalosporins/pharmacology
Clone Cells
Conjugation, Genetic
Cross Infection/drug therapy
Disease Outbreaks
Drug Resistance, Multiple, Bacterial/genetics
Enterobacteriaceae Infections/drug therapy
Female
Gene Expression
Gene Transfer, Horizontal
Greece/epidemiology
Humans
Male
Methyltransferases/genetics
Microbial Sensitivity Tests
Middle Aged
Plasmids/chemistry
Providencia/drug effects
Quinolones/pharmacology
Replicon
Survival Analysis
beta-Lactamases/genetics

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Oikonomou, O., Liakopoulos, A., Phee, L. M., Betts, J. W., Mevius, D., & Wareham, D. W. (2016). Providencia stuartii Isolates from Greece: Co-Carriage of Cephalosporin (blaSHV-5, blaVEB-1), Carbapenem (blaVIM-1), and Aminoglycoside (rmtB) Resistance Determinants by a Multidrug-Resistant Outbreak Clone. Microbial drug resistance (Larchmont, N.Y.), 22(5), 379-86. https://doi.org/10.1089/mdr.2015.0215

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title = "Providencia stuartii Isolates from Greece: Co-Carriage of Cephalosporin (blaSHV-5, blaVEB-1), Carbapenem (blaVIM-1), and Aminoglycoside (rmtB) Resistance Determinants by a Multidrug-Resistant Outbreak Clone",

abstract = "Providencia stuartii has emerged as an important nosocomial pathogen. We describe an outbreak due to a multidrug-resistant strain over a 4-month period in a critical care unit in Athens. Molecular typing revealed each of the isolates to be clonally related with coresistance to cephalosporins, carbapenems, aminoglycosides, and quinolones. Each isolate contained a 220-kb multi-replicon (IncA/C and IncR) conjugative plasmid encoding TEM-1, SHV-5, VEB-1, and VIM-1 β-lactamases and the 16S rDNA methylase RmtB. Antimicrobial therapy was unsuccessful in 3 of 6 cases, and resistance was readily transmissible to susceptible strains of Escherichia coli by transformation and conjugation. This highlights the clinical importance of P. stuartii and its ability to disseminate critical resistance determinants to other bacterial pathogens.",

keywords = "Adult, Aged, Aminoglycosides/pharmacology, Anti-Bacterial Agents/pharmacology, Bacterial Proteins/genetics, Carbapenems/pharmacology, Cephalosporins/pharmacology, Clone Cells, Conjugation, Genetic, Cross Infection/drug therapy, Disease Outbreaks, Drug Resistance, Multiple, Bacterial/genetics, Enterobacteriaceae Infections/drug therapy, Female, Gene Expression, Gene Transfer, Horizontal, Greece/epidemiology, Humans, Male, Methyltransferases/genetics, Microbial Sensitivity Tests, Middle Aged, Plasmids/chemistry, Providencia/drug effects, Quinolones/pharmacology, Replicon, Survival Analysis, beta-Lactamases/genetics",

author = "Olga Oikonomou and Apostolos Liakopoulos and Phee, \{Lynette M\} and Betts, \{Jonathan W.\} and Dik Mevius and Wareham, \{David W\}",

year = "2016",

month = jul,

doi = "10.1089/mdr.2015.0215",

language = "English",

volume = "22",

pages = "379--86",

journal = "Microbial drug resistance (Larchmont, N.Y.)",

issn = "1076-6294",

publisher = "Mary Ann Liebert inc",

number = "5",

}

Oikonomou, O, Liakopoulos, A, Phee, LM, Betts, JW, Mevius, D & Wareham, DW 2016, 'Providencia stuartii Isolates from Greece: Co-Carriage of Cephalosporin (blaSHV-5, blaVEB-1), Carbapenem (blaVIM-1), and Aminoglycoside (rmtB) Resistance Determinants by a Multidrug-Resistant Outbreak Clone', Microbial drug resistance (Larchmont, N.Y.), vol. 22, no. 5, pp. 379-86. https://doi.org/10.1089/mdr.2015.0215

Providencia stuartii Isolates from Greece: Co-Carriage of Cephalosporin (blaSHV-5, blaVEB-1), Carbapenem (blaVIM-1), and Aminoglycoside (rmtB) Resistance Determinants by a Multidrug-Resistant Outbreak Clone. / Oikonomou, Olga; Liakopoulos, Apostolos; Phee, Lynette M et al.
In: Microbial drug resistance (Larchmont, N.Y.), Vol. 22, No. 5, 07.2016, p. 379-86.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Providencia stuartii Isolates from Greece

T2 - Co-Carriage of Cephalosporin (blaSHV-5, blaVEB-1), Carbapenem (blaVIM-1), and Aminoglycoside (rmtB) Resistance Determinants by a Multidrug-Resistant Outbreak Clone

AU - Oikonomou, Olga

AU - Liakopoulos, Apostolos

AU - Phee, Lynette M

AU - Betts, Jonathan W.

AU - Mevius, Dik

AU - Wareham, David W

PY - 2016/7

Y1 - 2016/7

N2 - Providencia stuartii has emerged as an important nosocomial pathogen. We describe an outbreak due to a multidrug-resistant strain over a 4-month period in a critical care unit in Athens. Molecular typing revealed each of the isolates to be clonally related with coresistance to cephalosporins, carbapenems, aminoglycosides, and quinolones. Each isolate contained a 220-kb multi-replicon (IncA/C and IncR) conjugative plasmid encoding TEM-1, SHV-5, VEB-1, and VIM-1 β-lactamases and the 16S rDNA methylase RmtB. Antimicrobial therapy was unsuccessful in 3 of 6 cases, and resistance was readily transmissible to susceptible strains of Escherichia coli by transformation and conjugation. This highlights the clinical importance of P. stuartii and its ability to disseminate critical resistance determinants to other bacterial pathogens.

AB - Providencia stuartii has emerged as an important nosocomial pathogen. We describe an outbreak due to a multidrug-resistant strain over a 4-month period in a critical care unit in Athens. Molecular typing revealed each of the isolates to be clonally related with coresistance to cephalosporins, carbapenems, aminoglycosides, and quinolones. Each isolate contained a 220-kb multi-replicon (IncA/C and IncR) conjugative plasmid encoding TEM-1, SHV-5, VEB-1, and VIM-1 β-lactamases and the 16S rDNA methylase RmtB. Antimicrobial therapy was unsuccessful in 3 of 6 cases, and resistance was readily transmissible to susceptible strains of Escherichia coli by transformation and conjugation. This highlights the clinical importance of P. stuartii and its ability to disseminate critical resistance determinants to other bacterial pathogens.

KW - Adult

KW - Aged

KW - Aminoglycosides/pharmacology

KW - Anti-Bacterial Agents/pharmacology

KW - Bacterial Proteins/genetics

KW - Carbapenems/pharmacology

KW - Cephalosporins/pharmacology

KW - Clone Cells

KW - Conjugation, Genetic

KW - Cross Infection/drug therapy

KW - Disease Outbreaks

KW - Drug Resistance, Multiple, Bacterial/genetics

KW - Enterobacteriaceae Infections/drug therapy

KW - Female

KW - Gene Expression

KW - Gene Transfer, Horizontal

KW - Greece/epidemiology

KW - Humans

KW - Male

KW - Methyltransferases/genetics

KW - Microbial Sensitivity Tests

KW - Middle Aged

KW - Plasmids/chemistry

KW - Providencia/drug effects

KW - Quinolones/pharmacology

KW - Replicon

KW - Survival Analysis

KW - beta-Lactamases/genetics

U2 - 10.1089/mdr.2015.0215

DO - 10.1089/mdr.2015.0215

M3 - Article

C2 - 27380549

SN - 1076-6294

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JO - Microbial drug resistance (Larchmont, N.Y.)

JF - Microbial drug resistance (Larchmont, N.Y.)

IS - 5

ER -

Oikonomou O, Liakopoulos A, Phee LM, Betts JW, Mevius D, Wareham DW. Providencia stuartii Isolates from Greece: Co-Carriage of Cephalosporin (blaSHV-5, blaVEB-1), Carbapenem (blaVIM-1), and Aminoglycoside (rmtB) Resistance Determinants by a Multidrug-Resistant Outbreak Clone. Microbial drug resistance (Larchmont, N.Y.). 2016 Jul;22(5):379-86. doi: 10.1089/mdr.2015.0215