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      Carbapenemase-producing Enterobacteriaceae, U.S. Rivers

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          Abstract

          Identification of imipenem-resistant Enterobacter asburiae isolates from distant rivers indicates an environmental reservoir for carbapenemase genes.

          Abstract

          Our study was initiated by previous isolation of 30 imipenem-resistant, gram-negative rods from 7 of 16 U.S. rivers sampled from 1999 to 2001. Imipenem hydrolysis was detected in 22 of those isolates identified as Enterobacter asburiae. Random amplified polymorphism DNA analysis showed that these E. asburiae isolates were genetically indistinguishable. An identical clavulanic acid–inhibited β-lactamase IMI-2 was identified from each isolate that shared 99% and 97% amino acid identity with the chromosome-encoded β-lactamases IMI-1 and NmcA, respectively, from E. cloacae clinical isolates. The bla IMI-2 gene was located on a self-transferable 66-kb plasmid. Sequence analysis of a cloned 5.5-kb DNA fragment obtained from 1 of the imipenem-resistant E. asburiae isolates identified an upstream LysR-type regulator gene that explained inducibility of IMI-2 expression. β-Lactamase IMI-2 is the first inducible and plasmid-encoded carbapenemase. Identification of clonally related E. asburiae isolates from distant rivers indicates an environmental and enterobacterial reservoir for carbapenemase genes.

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          Degenerate oligonucleotide-primed PCR: general amplification of target DNA by a single degenerate primer.

          A version of the polymerase chain reaction (PCR), termed degenerate oligonucleotide-primed PCR (DOP-PCR), which employs oligonucleotides of partially degenerate sequence, has been developed for genome mapping studies. This degeneracy, together with a PCR protocol utilizing a low initial annealing temperature, ensures priming from multiple (e.g., approximately 10(6) in human) evenly dispersed sites within a given genome. Furthermore, as efficient amplification is achieved from the genomes of all species tested using the same primer, the method appears to be species-independent. Thus, for the general amplification of target DNA, DOP-PCR has advantages over interspersed repetitive sequence PCR (IRS-PCR), which relies on the appropriate positioning of species-specific repeat elements. In conjunction with chromosome flow sorting, DOP-PCR has been applied to the characterization of abnormal chromosomes and also to the cloning of new markers for specific chromosome regions. DOP-PCR therefore represents a rapid, efficient, and species-independent technique for general DNA amplification.
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            Emerging carbapenemases in Gram-negative aerobes.

            Carbapenemases may be defined as beta-lactamases that significantly hydrolyze at least imipenem or/and meropenem. Carbapenemases involved in acquired resistance are of Ambler molecular classes A, B, and D. Class A, clavulanic acid-inhibited carbapenemases are rare. They are either chromosomally encoded (NMC-A, Sme-1 to Sme-3, IMI-1) in Enterobacter cloacae and Serratia marcescens, or plasmid encoded, such as KPC-1 in Klebsiella pneumoniae and GES-2 in Pseudomonas aeruginosa, the latter being a point-mutant of the clavulanic acid-inhibited extended-spectrum beta-lactamase GES-1. The class B enzymes are the most clinically significant carbapenemases. They are metalloenzymes of the IMP or VIM series. They have been reported worldwide but mostly from South East Asia and Europe. Metalloenzymes, whose genes are plasmid and integron located, hydrolyze virtually all beta-lactams except aztreonam. Finally, the class D carbapenemases are increasingly reported in Acinetobacter baumannii but compromise imipenem and meropenem susceptibility only marginally. The sources of the acquired carbapenemase genes remain unknown, as does the relative importance of the spread of epidemic strains as opposed to the spread of plasmid- or integron-borne genes. Because most of these carbapenemases confer only reduced susceptibility to carbapenems in Enterobacteriaceae, they may remain underestimated as a consequence of the lack of their detection.
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              The isolation of antibiotic-resistant salmonella from retail ground meats.

              Salmonella is a leading cause of foodborne illness. The emergence of antimicrobial-resistant salmonella is associated with the use of antibiotics in animals raised for food; resistant bacteria can be transmitted to humans through foods, particularly those of animal origin. We identified and characterized strains of salmonella isolated from ground meats purchased in the Washington, D.C., area. Salmonella was isolated from samples of ground chicken, beef, turkey, and pork purchased at three supermarkets. The isolates were characterized by serotyping, antimicrobial-susceptibility testing, phage typing, and pulsed-field gel electrophoresis. The polymerase chain reaction and DNA sequencing were used to identify resistance integrons and extended spectrum beta-lactamase genes. Of 200 meat samples, 41 (20 percent) contained salmonella, with a total of 13 serotypes. Eighty-four percent of the isolates were resistant to at least one antibiotic, and 53 percent were resistant to at least three antibiotics. Sixteen percent of the isolates were resistant to ceftriaxone, the drug of choice for treating salmonellosis in children. Bacteriophage typing identified four isolates of Salmonella enterica serotype typhimurium definitive type 104 (DT104), one of DT104b, and two of DT208. Five isolates of S. enterica serotype agona had resistance to 9 antibiotics, and the two isolates of serotype typhimurium DT208 were resistant to 12 antibiotics. Electrophoretic patterns of DNA that were indistinguishable from one another were repeatedly found in isolates from different meat samples and different stores. Eighteen isolates, representing four serotypes, had integrons with genes conferring resistance to aminoglycosides, sulfonamides, trimethoprim, and beta-lactams. Resistant strains of salmonella are common in retail ground meats. These findings provide support for the adoption of guidelines for the prudent use of antibiotics in food animals and for a reduction in the number of pathogens present on farms and in slaughterhouses. National surveillance for antimicrobial-resistant salmonella should be extended to include retail meats.
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                Author and article information

                Journal
                Emerg Infect Dis
                Emerging Infect. Dis
                EID
                Emerging Infectious Diseases
                Centers for Disease Control and Prevention
                1080-6040
                1080-6059
                February 2005
                : 11
                : 2
                : 260-264
                Affiliations
                [* ]University Paris XI, Paris, France;
                []Washburn University, Topeka, Kansas, USA
                Author notes
                Address for correspondence: Nordmann P. Service de Bactériologie-Virologie, Hôpital de Bicêtre, 78, rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, France; fax: 33-1-45-21-63-40; email: nordmann.patrice@ 123456bct.ap-hop-paris.fr
                Article
                03-0684
                10.3201/eid1102.030684
                3320444
                15752444
                a2012075-ac22-43a6-9036-582fcada2c84
                History
                Categories
                Research
                Research

                Infectious disease & Microbiology
                environment,imipenem,research,beta-lactamase,resistance,enterobacteriaceae

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