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Dispersal of Carbapenemase blaVIM-1 Gene Associated with Different Tn402 Variants, Mercury Transposons, and Conjugative Plasmids in Enterobacteriaceae and Pseudomonas aeruginosa

ABSTRACT The emergence of blaVIM-1 within four different genetic platforms from distinct Enterobacteriaceae and Pseudomonas aeruginosa isolates in an area with a low prevalence of metallo-β-lactamase producers is reported. Forty-three VIM-1-producing isolates (including 19 Enterobacter cloacae, 2 Escherichia coli, and 2 P. aeruginosa isolates, 18 Klebsiella pneumoniae isolate, and 2 Klebsiella oxytoca isolate) recovered from 2005 to 2007 and corresponding to 15 pulsed-field gel electrophoresis types were studied. The Enterobacteriaceae isolates corresponded to a hospital outbreak, and the P. aeruginosa isolates were sporadically recovered. The genetic context of the integrons carrying blaVIM-1 (arbitrarily designated types A, B, C, and D) was characterized by PCR mapping based on known Tn402 and mercury transposons and further sequencing. Among Enterobacteriaceae isolates, blaVIM-1 was part of integrons located either in an In2-Tn402 element linked to Tn21 (type A; In110-blaVIM-1-aacA4-aadA1) or in a Tn402 transposon lacking the whole tni module [type B; In113-blaVIM-1-aacA4-dhfrII (also called dfrB1)-aadA1-catB2] and the transposon was associated with an IncHI2 or IncI1 plasmid, respectively. Among P. aeruginosa isolates, blaVIM-1 was part of a new gene cassette array located in a defective Tn402 transposon carrying either tniBΔ3 and tniA (type C; blaVIM-1-aadA1) or tniC and ΔtniQ (type D; blaVIM-1-aadB), and both Tn402 variants were associated with conjugative plasmids of 30 kb. The dissemination of blaVIM-1 was associated with different genetic structures and bacterial hosts, depicting a complex emergence and evolutionary network scenario in our facility, Ramón y Cajal University Hospital, Madrid, Spain. Knowledge of the complex epidemiology of blaVIM-1 is necessary to control this emerging threat.