1887

Abstract

A 30 month prospective study of species encountered in the Central Pathology Laboratory of St James's Hospital, Dublin, Ireland, was conducted to investigate the prevalence and molecular epidemiology of carbapenem resistance in such isolates. genomic species 3 (AG3) was found to be the predominant species (45/114, 39 %) in our institution. A total of 11 % of all species (12/114) and 22 % of AG3 isolates (10/45) were carbapenem resistant. Carbapenem resistance was mediated by Ambler class D -lactamase OXA-23 in all 12 isolates, with insertion sequence IS found upstream of . IS was also found upstream of , which encodes the enzyme AmpC, in an isolate, and upstream of the aminoglycoside-acetyltransferase-encoding gene in three AG3 isolates. Inter-species plasmidic transfer was most likely involved in the emergence and spread of among the isolates within our institution. The emergence of carbapenem resistance was associated not only with prior carbapenem use but also with the use of other antimicrobial agents, most notably -lactam/-lactamase-inhibitor combinations. The study demonstrated the emerging trend of carbapenem resistance in the wider context of the genus, and reiterated the paramount importance of the prudent use of antimicrobial agents, stringent infection control measures and resistance surveillance of pathogens.

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2009-02-01
2024-03-29
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