TY - JOUR T1 - Evaluation of Clonality and Carbapenem Resistance Mechanisms among <span class="named-content genus-species" id="named-content-1">Acinetobacter baumannii</span>-<span class="named-content genus-species" id="named-content-2">Acinetobacter calcoaceticus</span> Complex and <span class="named-content genus-species" id="named-content-3">Enterobacteriaceae</span> Isolates Collected in European and Mediterranean Countries and Detection of Two Novel β-Lactamases, GES-22 and VIM-35 JF - Antimicrobial Agents and Chemotherapy JO - Antimicrob. Agents Chemother. SP - 7358 LP - 7366 DO - 10.1128/AAC.03930-14 VL - 58 IS - 12 AU - Castanheira, Mariana AU - Costello, Sarah E. AU - Woosley, Leah N. AU - Deshpande, Lalitagauri M. AU - Davies, Todd A. AU - Jones, Ronald N. Y1 - 2014/12/01 UR - http://aac.asm.org/content/58/12/7358.abstract N2 - We evaluated doripenem-resistant Acinetobacter baumannii-Acinetobacter calcoaceticus complex (ACB; n = 411) and Enterobacteriaceae (n = 92) isolates collected from patients from 14 European and Mediterranean countries during 2009 to 2011 for the presence of carbapenemase-encoding genes and clonality. Following susceptibility testing, carbapenem-resistant (doripenem MIC, &gt;2 μg/ml) isolates were screened for carbapenemases. New β-lactamase genes were expressed in a common background and susceptibility was tested. Class 1 integrons were sequenced. Clonality was evaluated by pulsed-field gel electrophoresis and multilocus sequence typing (Pasteur scheme). Relative expression of β-lactam intrinsic resistance mechanisms was determined for carbapenemase-negative Enterobacteriaceae. ACB and Enterobacteriaceae displayed 58.9 and 0.9% doripenem resistance, respectively. blaOXA-23, blaOXA-58, and blaOXA-24/OXA-40 were detected among 277, 77, and 29 ACB, respectively (in 8, 6, and 5 countries). Ten Turkish isolates carried blaGES-11 or blaGES-22. GES-22 (G243A and M169L mutations in GES-1) had an extended-spectrum β-lactamase profile. A total of 33 clusters of ≥2 ACB isolates were observed, and 227 isolates belonged to sequence type 2/international clone II. Other international clones were limited to Turkey and Israel. Doripenem-resistant Enterobacteriaceae increased significantly (0.7 to 1.6%), and 15 blaKPC-2- and 22 blaKPC-3-carrying isolates, mostly belonging to clonal complexes 11 and 258, were observed. Enterobacteriaceae isolates producing OXA-48 (n = 16; in Turkey and Italy), VIM-1 (n = 10; in Greece, Poland, and Spain), VIM-26 (n = 1; in Greece), and IMP-19, VIM-4, and the novel VIM-35 (n = 1 each from Poland) were detected. VIM-35 had one substitution compared to VIM-1 (A235T) and a similar susceptibility profile. One or more resistance mechanisms were identified in 4/6 carbapenemase-negative Enterobacteriaceae. This broad evaluation confirms results from country-specific surveys and shows a highly diverse population of carbapenemase-producing ACB and Enterobacteriaceae in Europe and Mediterranean countries. ER -