Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 3, May-June, p. 539–544

doi: 10.17219/acem/34150

Publication type: original article

Language: English

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Distribution of 16S rRNA Methylases Among Different Species of Aminoglycoside-Resistant Enterobacteriaceae in a Tertiary Care Hospital in Poland

Katarzyna Piekarska1,A,D,F, Katarzyna Zacharczuk1,B,C, Tomasz Wołkowicz1,C, Magdalena Rzeczkowska1,C, Elżbieta Bareja2,B, Monika Olak2,B, Rafał Gierczyński1,E,F

1 Department of Bacteriology, National Institute of Public Health-National Institute of Hygiene, Warszawa, Poland

2 Department of Laboratory Diagnostics, Military Institute of Medicine, Warszawa, Poland

Abstract

Background. Aminoglycosides are a group of antimicrobial agents still the most commonly used in the treatment of life-threatening bacterial infections in human and animals. The emergence and spread of 16S rRNA methylases, which confer high-level resistance to the majority of clinically relevant aminoglycosides, constitute a major public health concern.
Objectives. Our goal was to evaluate the distribution of 16S rRNA methylases among different species of Enterobacteriaceae during a five month-long survey in a tertiary hospital in Warszawa, Poland.
Material and Methods. In the survey, a total of 1770 non-duplicate clinical isolates were collected from all hospital wards in a tertiary hospital in Warszawa, Poland. The survey was conducted between 19 April and 19 September 2010. The ability to produce 16S rRNA methylase was examined by determining MICs for gentamicin, kanamycin, amikacin by means of the agar dilution method. The isolates resistant to high concentration of aminoglycosides were PCR tested for genes: armA, rmtA, rmtB and rmtC. PCR products were subjected to DNA sequencing by the Sanger method. The genetic similarity of the ArmA-producing isolates was analysed by pulsed-filed gel electrophoresis (PFGE).
Results. ArmA was the only 16S rRNA methylase detected in 20 of 1770 tested isolates. The overall prevalence rate of ArmA was 1.13%. In K. pneumoniae (n = 742), P. mirabilis (n = 130), and E. cloacae (n = 253) collected in the survey, the prevalence of ArmA was 0.4%, 0.8% and 5.9%, respectively. The PFGE revealed both horizontal and clonal spread of the armA gene in the hospital.
Conclusion. The prevalence of 16S rRNA methylase ArmA reported in this study is significantly higher than observed in other countries in Europe.

Key words

Enterobacteriaceae, 16S rRNA methylases, ArmA

References (20)

  1. Yamane K, Wachino J, Suzuki S, Shibata N, Kato H, Shibayama K, Kimura K, Kai K, Ishikawa S, Ozawa Y, Konda T, Arakawa Y: 16S rRNA methylase-producing, gram-negative pathogens, Japan. Emerging Inf Dis 2007, 13, 642–646.
  2. Bogaerts P, Galimand M, Bauraing C, Deplano A, Vanhoof R, de Mendonca R, Rodriguez-Villalobos H, Struelens M, Glupczynski Y: Emergence of ArmA and RmtB aminoglycoside resistance 16S rRNA methylases in Belgium. J Antimicrob Chemoth 2007, 59, 459–464.
  3. Galani I, Souli M, Panagea T, Poulakou G, Kanellakopoulou K, Giamarellou H: Prevalence of 16S rRNA methylase genes in Enterobacteriacea isolates from a Greek University Hospital. Clin Microbiol Infect 2012, 18, E52–E54.
  4. Yan JJ, Wu JJ, Ko WCh, Tsai SH, Chuang ChL, Wu HM, Lu YJ, Li JD: Plasmid-mediated 16S rRNA methylases conferring high-level aminoglycoside resistance in Escherichia coli and Klebsiella pneumoniae isolates from two Taiwanese hospitals. J Antimicrob Chemother 2004, 54, 1007–1012.
  5. Berçot B, Poirel L, Nordmann P: Plasmid-mediated 16S rRNA methylases among extended-spectrum β-lactamaseproducing Enterobacteriaceae isolates. Antimicrob Agents Chemother 2008, 52, 4526–4527.
  6. Yang J, Ye L, Wang W, Luo Y, Zhang Y, Han L: Diverse prevalence of 16S rRNA methylase genes armA and rmtB amongst clinical multidrug-resistant Escherichia coli and Klebsiella pneumoniae isolates. Int J Antimicrob Agents 2011, 38, 348–351.
  7. Wachino J, Arakawa Y: Exogenously acquired 16S rRNA methyltransferases found in aminoglycoside-resistant pathogenic Gram-negative bacteria: An update. Drug Resistance Updates 2012, 15, 133–148.
  8. Fritsche TR, Castanheira M, Miller GH, Jones RN, Armstrong ES: Detection of methyltransferases conferring high-level resistance to aminoglycosides in Enterobacteriaceae from Europe, North America, and Latin America. Antimicrob Agents Chemother 2008, 52, 1843–1845.
  9. Galimand M, Courvalin P, Lambert T: Plasmid-mediated high-level resistance to aminoglycosides in Enterobacteriaceae due to 16S rRNA methylation. Antimicrob Agents Chemother 2003, 47, 2565–2571.
  10. Zacharczuk K, Piekarska K, Szych J, Zawidzka E, Sulikowska A, Wardak S, Jagielski M, Gierczyński R: Emergence of Klebsiella pneumoniae coproducing KPC-2 and 16S rRNA methylase ArmA in Poland. Antimicrob Agents Chemother 2011, 55, 443–446.
  11. Sabtcheva S, Saga T, Kantardjiev T, Ivanova M, Ishii Y, Kaku M: Nosocomial spread of armA-mediated highlevel aminoglycoside resistance in Enterobacteriaceae isolates producing CTX-M-3 beta-lactamase in cancer hospital in Bulgaria. J Chemother 2008, 20, 593–599.
  12. Gołębiewski M, Kern-Zdanowicz I, Zienkiewicz M, Adamczyk M, Zylińska J, Baraniak A, Gniadkowski M, Bardowski J, Cegłowski P: Complete nucleotide sequence of the pCTX-M3 plasmid and its involvement in spread of extended-spectrum β-lactamase gene blaCTX-M-3. Antimicrob Agents Chemother 2007, 51, 3789–3795.
  13. Clinical and Laboratory Standards Institute (CLSI). Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; approved standard, 8th ed. Document M07-A8. CLSI, Wayne, PA, USA 2009.
  14. Zacharczuk K, Piekarska K, Szych J, Jagielski M, Hidalgo L, Millán ÁS, Gutiérrez B, Rastawicki W, Gonzáles-Zorn B, Gierczyński R: Plazmid-borne 16S rRNA methylase ArmA in aminoglicoside – resistant Klebsiella pneumoniae in Poland. J Med Microbiol 2011, 60, 1306–1311.
  15. EARS-Net Annual Reports. Antimicrobial resistance surveillance in Europe 2010. Annual report of the European Antimicrobial Resistance Surveillance Network (www.ecdc.europa.eu).
  16. Wu Q, Zhang Y, Han L, Sun J, Ni Y: Plasmid-mediated 16S rRNA methylases in aminoglycoside-resistant Enterobacteriaceae isolates in Shinghai, China. Antimicrob Agents Chemother 2009, 53, 271–272.
  17. Kang HY, Kim KY, Kim J, Lee JCh, Lee YCh, Cho DCh, Seol SY: Distribution of conjugative-plasmid-mediated 16S rRNA methylase genes among amikacin-resistant Enterobacteriaceae isolates collected in 1995 to 1998 and 2001 to 2006 at a University Hospital in South Korea and identification of conjugative plasmids mediating dissemination of 16S rRNA methylase. J Clin Microbiol 2008, 46, 700–706.
  18. Hopkins KL, Escudero JA, Hidalgo L, Gonzalez-Zorn B: 16S rRNA methyltransferase RmtC in Salmonella enterica serovar Virchow. Emerg Infect Dis 2010, 16, 712–715.
  19. Wachino J, Shibayama K, Kurokawa H, Kimura K, Yamane K, Suzuki S, Shibata N, Ike Y, Arakawa Y: Novel plasmid-mediated 16S rRNA m1A1408 methyltransferase, NpmA, found in a clinically isolated Escherichia coli strain resistant to structurally diverse aminoglycosides. Antimicrob Agents Chemother 2007, 51, 4401–4409.
  20. Galimand M, Sabtcheva S, Courvalin P, Lambert T: Worldwide disseminated armA aminoglycoside resistance methylase gene is borne by composite transposon Tn1548. Antimicrob Agents Chemother 2005, 49, 2949–2953.