RESUMEN
The objectives of this work were to collect and characterize vancomycin-resistant Enterococcus faecium (VREF) clinical isolates from Hungary and Serbia and to analyse their genetic relatedness. VREF isolates were initially typed by PFGE. A selection of VREF isolates representing all participating hospitals was further examined by multiple-locus variable-number tandem repeat analysis (MLVA) and multilocus sequence typing (MLST). VanB VREF isolates (n=18) recovered from blood, urine and faecal cultures at a Budapest hospital between August 2003 and December 2004 were molecularly characterized. Macrorestriction analysis of the isolates revealed their monoclonal relatedness. A cluster of infections caused by 2 distinct VanA VREF clones recovered from 6 departments was identified in a Belgrade hospital in Serbia. The vanA resistance determinant was transferable by in vitro conjugation experiments. We also identified 2 vanA-positive E. gallinarum blood culture isolates in this Belgrade hospital. Molecular typing of representative VREF isolates from Hungary and Serbia by MLVA and MLST revealed that all tested isolates belonged to MLST complex CC17 and the corresponding MLVA cluster 1. Our results extend the documented occurrence of CC17 to a new region in Europe.
Asunto(s)
Antibacterianos/farmacología , Enterococcus faecium , Infecciones por Bacterias Grampositivas/microbiología , Resistencia a la Vancomicina/genética , Proteínas Bacterianas/genética , Análisis por Conglomerados , Conjugación Genética , Dermatoglifia del ADN , Electroforesis en Gel de Campo Pulsado , Enterococcus faecium/clasificación , Enterococcus faecium/efectos de los fármacos , Enterococcus faecium/genética , Enterococcus faecium/aislamiento & purificación , Humanos , Hungría , Proteínas de la Membrana/genética , Metiltransferasas/genética , Pruebas de Sensibilidad Microbiana , Repeticiones de Minisatélite , Filogenia , Reacción en Cadena de la Polimerasa , Análisis de Secuencia de ADN , SerbiaRESUMEN
VIM metallo-beta-lactamase-producing serotype O11 or O12 Pseudomonas aeruginosa isolates infecting or colonising 19 patients from seven hospitals were reported in Hungary between 2003 and 2005. In this study we characterised VIM-producing Pseudomonas spp. clinical isolates from two novel locations in Hungary; we identified three new bla(VIM) carrying integron types and the presence of the bla(VIM-2) allele in Hungary. By applying various typing techniques, including multilocus sequence typing, we revealed an important role of two international clonal complexes, CC4 and CC11, in the dissemination of bla(VIM)-positive P. aeruginosa in hospitals in Hungary. Isolate P12-Q, a representative strain from France of the major European multiresistant P12 clone, displayed ST111 which, according to eBURST analysis, is the presently calculated founder sequence type of CC4. This is in accordance with the wide geographic distribution of the P12 clone. Our data indicate that, although the CC4 clonal complex includes serotype O1 and O6 isolates as well, it also contains the P12 clone. We characterised a P. aeruginosa nosocomial clone with a singleton sequence type (ST313), that may have acquired bla(VIM-2) and bla(VIM-4) gene cassettes from a yet unidentified local gene pool in Hungary.
Asunto(s)
Técnicas de Tipificación Bacteriana/métodos , Infecciones por Pseudomonas/microbiología , Pseudomonas aeruginosa/clasificación , Pseudomonas aeruginosa/enzimología , beta-Lactamasas/genética , Farmacorresistencia Bacteriana , Humanos , Hungría/epidemiología , Integrones , Pruebas de Sensibilidad Microbiana , Datos de Secuencia Molecular , Fenotipo , Infecciones por Pseudomonas/epidemiología , Pseudomonas aeruginosa/efectos de los fármacos , Pseudomonas aeruginosa/genética , Técnica del ADN Polimorfo Amplificado Aleatorio , Análisis de Secuencia de ADN , beta-Lactamasas/metabolismoRESUMEN
VIM metallo-beta-lactamase-producing serotype O11 or O12 Pseudomonas aeruginosa isolates infecting or colonizing 19 patients from seven hospitals in Hungary were characterized between October 2003 and November 2005. Macrorestriction analysis revealed the involvement of hospitals from three different towns in northwest Hungary in an outbreak caused by VIM-4-producing P. aeruginosa.
Asunto(s)
Epidemiología Molecular , Infecciones por Pseudomonas/microbiología , Pseudomonas/enzimología , Pseudomonas/aislamiento & purificación , beta-Lactamasas/metabolismo , Secuencia de Bases , Brotes de Enfermedades , Electroforesis en Gel de Campo Pulsado , Humanos , Hungría/epidemiología , Integrones , Pruebas de Sensibilidad Microbiana , Datos de Secuencia Molecular , Pseudomonas/clasificación , Infecciones por Pseudomonas/epidemiología , Estudios Retrospectivos , beta-Lactamasas/genéticaRESUMEN
The first integron-borne metallo-beta-lactamase gene was isolated in Hungary. The bla(VIM-4) gene is located on a class 1 integron that also carries a novel bla(OXA)-like gene. The integron is harbored by a serotype O12 Pseudomonas aeruginosa strain and shows high structural similarity to integrons isolated in Greece and Poland.
Asunto(s)
Carbapenémicos/farmacología , Integrones/genética , Infecciones por Pseudomonas/microbiología , Pseudomonas aeruginosa/efectos de los fármacos , Pseudomonas aeruginosa/genética , beta-Lactamasas/genética , Secuencia de Aminoácidos , Secuencia de Bases , Cartilla de ADN , ADN Bacteriano/genética , Farmacorresistencia Bacteriana , Hungría , Pruebas de Sensibilidad Microbiana , Datos de Secuencia Molecular , Plásmidos/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , SerotipificaciónRESUMEN
UNLABELLED: Case reports and review of the literature. INTRODUCTION: Severe toxic shock syndrome caused by invasive infection with pyogenic bacteria Staphylococcus aureus or group A Streptococcus pyogenes, with high mortality rates in cases of the latter, remained one of the most problematic chapters of critical care medicine to date. AIMS: To give an overview on the epidemiology, clinical manifestations, the complex therapeutical approaches of the syndrome and, on the role and mechanisms of action of bacterial superantigens in the pathophysiological processes as well. METHODS AND RESULTS: Literary data, and some illustrative selected cases demonstrate that, the incidence of TSS shows increasing tendency worldwide and, that otherwise healthy, younger people are the most frequently affected. As for prognosis: early diagnosis and treatment with sufficient radicality are of decisive importance.