Outbreaks of multidrug-resistant Pseudomonas aeruginosa in community hospitals in Japan

Jun Ichiro Sekiguchi, Tsukasa Asagi, Tohru Miyoshi-Akiyama, Atsushi Kasai, Yukie Mizuguchi, Minako Araake, Tomoko Fujino, Hideko Kikuchi, Satoru Sasaki, Hajime Watari, Tadashi Kojima, Hiroshi Miki, Keiji Kanemitsu, Hiroyuki Kunishima, Yoshihiro Kikuchi, Mitsuo Kaku, Hiroshi Yoshikura, Tadatoshi Kuratsuji, Teruo Kirikae

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Abstract

We previously reported an outbreak in a neurosurgery ward of catheter-associated urinary tract infection with multidrug-resistant (MDR) Pseudomonas aeruginosa strain IMCJ2.S1, carrying the 6′-N-aminoglycoside acetyltransferase gene [aac(6′)-Iae]. For further epidemiologic studies, 214 clinical isolates of MDRP. aeruginosa showing resistance to imipenem (MIC ≥ 16 μg/ml), amikacin (MIC ≥ 64 μg/ml), and ciprofloxacin (MIC ≥ 4 μg/ml) were collected from 13 hospitals in the same prefecture in Japan. We also collected 70 clinical isolates of P. aeruginosa that were sensitive to one or more of these antibiotics and compared their characteristics with those of the MDR P. aeruginosa isolates. Of the 214 MDR P. aeruginosa isolates, 212 (99%) were serotype O11. We developed a loop-mediated isothermal amplification (LAMP) assay and a slide agglutination test for detection of the aac(6′)-Iae gene and the AAC(6′)-Iae protein, respectively. Of the 212 MDR P. aeruginosa isolates, 212 (100%) and 207 (98%) were positive in the LAMP assay and in the agglutination test, respectively. Mutations of gyrA and parC genes resulting in amino acid substitutions were detected in 213 of the 214 MDR P. aeruginosa isolates (99%). Of the 214 MDR P. aeruginosa isolates, 212 showed pulsed-field gel electrophoresis patterns with ≥70% similarity to that of IMCJ2.S1 and 83 showed a pattern identical to that of IMCJ2.S1, indicating that clonal expansion of MDR P. aeruginosa occurred in community hospitals in this area. The methods developed in this study to detect aac(6′)-Iae were rapid and effective in diagnosing infections caused by various MDR P. aeruginosa clones.

Original languageEnglish
Pages (from-to)979-989
Number of pages11
JournalJournal of Clinical Microbiology
Volume45
Issue number3
DOIs
Publication statusPublished - 2007 Mar

ASJC Scopus subject areas

  • Microbiology (medical)

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    Sekiguchi, J. I., Asagi, T., Miyoshi-Akiyama, T., Kasai, A., Mizuguchi, Y., Araake, M., Fujino, T., Kikuchi, H., Sasaki, S., Watari, H., Kojima, T., Miki, H., Kanemitsu, K., Kunishima, H., Kikuchi, Y., Kaku, M., Yoshikura, H., Kuratsuji, T., & Kirikae, T. (2007). Outbreaks of multidrug-resistant Pseudomonas aeruginosa in community hospitals in Japan. Journal of Clinical Microbiology, 45(3), 979-989. https://doi.org/10.1128/JCM.01772-06