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Background  We investigate the evolving molecular epidemiology of metallo-β-lactamase (MBL)-producing  Pseudomonas aeruginosa  isolates collected in a 100 institution, nationwide surveillance study in Japan from 2004 to 2006.    Results  MBL-producers were detected in 23/996 isolates (2.3%) in 2004 and 21/992 (2.1%) in 2006. Antimicrobial resistance (specifically, carbapenem resistance) rates between two periods did not differ significantly. MBL-producers were more prevalent in urinary tract isolates.  bla  IMP-1  group was the most predominant (38 isolates, 80%), followed by 3  bla  IMP-7 , 2  bla  IMP-11  group, and 1  bla  VIM-1 . All MBL genes were identified in 16 different class 1 integrons, most of which were novel to INTEGRALL database. A total of 17 isolates of sequence type (ST) 235, a recognized worldwide drug-resistant lineage, were distributed in 5 geographic regions across Japan. ST235 isolates included a sublineage associated with In113-like integron. ST357 was identified in 14 isolates, 9 of which harboring a sole  bla  IMP-1  gene cassette (In994) were recovered from Chugoku region in 2004. ST357 isolates with  bla  IMP-11  group or ST235 with  bla  IMP-7  emerged in 2006. We also report for the first time the presence of novel  fosI  gene cassette in strains other than  Mycobacterium  spp.    Conclusions  Our data give an important “snapshot” of the molecular characteristics and dynamics of MBL-producing lineages in  P. aeruginosa  in Japan. The significant association of specific genotypes and integrons implies that dissemination and transmission of the preexisting resistant lineage, rather than horizontal gene transfer  in situ , might largely explain their endemicity.

bmc microbiology

Molecular analysis of the integrons of metallo-β-lactamase-producing Pseudomonas aeruginosa isolates collected by nationwide surveillance programs across Japan