4.7 Article

Carbapenemase-producing Enterobacteriaceae, US rivers

Journal

EMERGING INFECTIOUS DISEASES
Volume 11, Issue 2, Pages 260-264

Publisher

CENTERS DISEASE CONTROL & PREVENTION
DOI: 10.3201/eid1102.030684

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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 P-lactamase IMI-2 was identified from each isolate that shared 99% and 97% amino acid identity with the chromosome-encoded beta-lactamases IMI-1 and NmcA, respectively, from E cloacae clinical isolates. The blaIMI-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. P-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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