Article

Emergence of ArmA and RmtB aminoglycoside resistance 16S rRNA methylases in Belgium.

Laboratoire de Bactériologie, Cliniques Universitaires UCL de Mont-Godinne, 1 Av. Dr Gaston Thérasse, B-5530 Yvoir, Belgium.
Journal of Antimicrobial Chemotherapy (impact factor: 5.07). 04/2007; 59(3):459-64. DOI:10.1093/jac/dkl527 pp.459-64
Source: PubMed

ABSTRACT 16S rRNA methylase-mediated high-level resistance to aminoglycosides has been reported recently in clinical isolates of Gram-negative bacilli only from a limited number of countries. This study was conducted to investigate the occurrence of this type of resistance in clinical isolates of Enterobacteriaceae from two Belgian hospitals and the characteristics of the strains.
We screened for high-level gentamicin, tobramycin and amikacin resistance in clinical isolates of Enterobacteriaceae consecutively collected between 2000 and 2005 at two laboratories by PCR for the armA, rmtA and rmtB 16S rRNA methylase genes. The beta-lactamase presence in the strains was also determined by phenotypic and genotypic methods.
Overall armA genes were detected in 18 Klebsiella pneumoniae, Escherichia coli, Enterobacter aerogenes, Enterobacter cloacae and Citrobacter amalonaticus whereas rmtB was detected in a single E. coli isolate. The rmtA gene was not found. All 16S rRNA methylase-bearing strains produced extended-spectrum beta-lactamases (ESBLs), predominantly type CTX-M-3, as well as various types of beta-lactamases. In the majority of the strains, the armA gene was carried by conjugative plasmids of the IncL/M incompatibility group whereas rmtB was borne by an IncFI plasmid.
This is the first report of the emergence of 16S rRNA methylases in Enterobacteriaceae in Belgium. The rapid spread of multidrug-resistant isolates producing both ESBLs and 16S rRNA methylases raises clinical concern and may become a major therapeutic threat in the future.

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Keywords

16S rRNA methylase-bearing strains
 
16S rRNA methylases
 
18 Klebsiella pneumoniae
 
armA gene
 
Belgian hospitals
 
clinical concern
 
conjugative plasmids
 
Enterobacter aerogenes
 
Enterobacteriaceae consecutively
 
Escherichia coli
 
extended-spectrum beta-lactamases
 
genotypic methods
 
Gram-negative bacilli
 
high-level gentamicin
 
IncFI plasmid
 
IncL/M incompatibility group
 
rapid spread
 
rmtA gene
 
rmtB 16S rRNA methylase genes
 
single E. coli