Detection of Pseudomonas aeruginosa isolates producing VEB-type extended-spectrum β-lactamases in the United Kingdom

Neil Woodford*, Jiancheng Zhang, Mary E. Kaufmann, Susannah Yarde, Maria del Mar Tomas, Camelia Faris, Madhur S. Vardhan, Susan Dawson, Stephen I. Cotterill, David M. Livermore

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

51 Citations (Scopus)

Abstract

Objectives: The aim of this study was to investigate the presence of VEB enzymes among Pseudomonas spp. referred to the UK's national reference laboratory and with phenotypic evidence of extended-spectrum β-lactamase (ESBL) production. Methods: Antibiograms were analysed for Pseudomonas spp. referred from November 2003 to November 2007. Isolates with ≥4-fold ceftazidime/ clavulanate synergy were screened for blaVEB alleles. Genes encoding metallo-β-lactamases (blaMBL) were sought in isolates with positive imipenem/EDTA synergy tests. Selected PCR products were sequenced. PFGE of Spe I-digested genomic DNA was used to compare isolates. Results: Forty-nine (3.7%) of 1338 Pseudomonas spp. were considered potential ESBL producers; 40 were recovered for molecular testing. blaVEB alleles were detected in 32 Pseudomonas aeruginosa isolates, comprising diverse PFGE types, from 12 UK hospitals and 1 in India. One UK centre referred 15 isolates with VEB-1 enzyme; these were serotype O15, representing a single PFGE-defined strain that also produced VIM-10 metallo-carbapenemase. This strain was resistant to all β-lactams, aminoglycosides and ciprofloxacin, remaining susceptible only to colistin (MICs ≤1 mg/L). Two other P. aeruginosa isolates co-producing both VEB and VIM enzymes were received from two other UK hospitals; one isolate represented inter-hospital spread of the O15 strain and the second was distinct. Conclusions: VEB enzymes have not been reported previously in the UK, but were produced by 80% of Pseudomonas spp. with phenotypic evidence of ESBL production. They co-existed with VIM carbapenemases in two strains, with one responsible for a major hospital outbreak. The incidence of ESBLs may be underestimated in Pseudomonas because ESBL phenotypes can be masked by other β-lactam resistance mechanisms.

Original languageEnglish
Pages (from-to)1265-1268
Number of pages4
JournalJournal of Antimicrobial Chemotherapy
Volume62
Issue number6
DOIs
Publication statusPublished - 2008

Bibliographical note

Funding Information:
No external funding was provided for this work.

Keywords

  • ESBL
  • Hospital outbreak
  • International clone
  • VIM metallo-carbapenemase

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