Protracted Regional Dissemination of GIM-1-Producing Serratia marcescens in Western Germany.
Antimicrob Agents Chemother
; 61(3)2017 03.
Article
en En
| MEDLINE
| ID: mdl-27956426
The metallo-beta-lactamase GIM-1 has been found in various bacterial host species nearly exclusively in western Germany. However, not much is known about the epidemiology of GIM-1-positive Serratia marcescens Here we report on a surprisingly protracted regional dissemination. In-hospital transmission was investigated by using conventional epidemiological tools to identify spatiotemporal links. Strain typing was performed using pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing (WGS). Bayesian phylogeny was used to infer the time axis of the observed occurrence. Thirteen S. marcescens strains from 10 patients from 6 different German hospitals were investigated. Suspected in-hospital transmissions were confirmed by molecular typing at a higher resolution by WGS than by PFGE. A detailed sequence analysis demonstrated the spread of one predominant strain variant but also provided evidence for transfer of the blaGIM-1 gene cassette between different strains. A Bayesian phylogenetic analysis showed that the most recent common ancestor of the identified clonal cluster could be dated back to April 1993 (95% highest posterior density interval, January 1973 to March 2003) and that this strain might have already harbored the blaGIM-1 at that time and, therewith, years before the first detection of this resistance gene in clinical specimens. This study shows a long-standing clonal and plasmid-mediated expansion of GIM-1-producing S. marcescens that might have gone unnoticed in the absence of a standardized and effective molecular screening for carbapenemases. The systematic and early detection of resistance is thus highly advisable, especially for the prevention of potentially long-term dissemination that may progress beyond control.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Filogenia
/
Serratia marcescens
/
Beta-Lactamasas
/
Infección Hospitalaria
/
Infecciones por Serratia
/
Genoma Bacteriano
/
Resistencia betalactámica
Tipo de estudio:
Clinical_trials
/
Screening_studies
Límite:
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Antimicrob Agents Chemother
Año:
2017
Tipo del documento:
Article
País de afiliación:
Alemania
Pais de publicación:
Estados Unidos