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Background   bla  VIM-2  harboring  Pseudomonas aeruginosa  has been reported worldwide and considered as the most prevalent metallo-β-lactamase after NDM which are found horizontally transferable and mostly associated with integron gene cassettes. The present study investigates the genetic background, transmission dynamics as well as stability of  bla  VIM-2  in clinical isolates of  P. aeruginosa  harbor  bla  NDM-1  as well which were collected from October 2012 to September 2013.    Methods  Two  P. aeruginosa  strains harboring  bla  VIM-2  along with  bla  NDM-1  were isolated from Silchar Medical College and Hospital, India. Genetic environment of these resistance determinants was determined and transferability was checked by transformation and conjugation assay which was further confirmed by Southern hybridization. Replicon typing was performed to determine the incompatibility group of the resistant plasmid and their stability was checked by serial passage method. Antimicrobial susceptibility pattern of the isolates was determined and their clonal relatedness was checked by pulsed field gel electrophoresis.    Results   bla  VIM-2  was found to be horizontally transferable through an Inc F type plasmid of approximately 30 kb in size.  bla  VIM-2  was found to be associated with integron gene cassette and was flanked by two different types of cassette arrays. Both the isolates were co-harboring  bla  NDM-1  which was carried within Inc N type of plasmid with an approximate 24 kb in size and associated with IS Aba125  in their upstream region. Reduced susceptibility rate as well as high MIC range was observed in case of wild strains and transformants carrying  bla  VIM-2  and  bla  NDM-1 .    Conclusions  The detection of this co-existence of multiple carbapenem resistance genes in this part of world is worrisome and further investigation is required in order to trace the source and to initiate proper treatment option.

Occurrence of co-existing bla VIM-2 and bla NDM-1 in clinical isolates of Pseudomonas aeruginosa from India