Antimicrobial Susceptibility and Molecular Characterization of Carbapenemase-Producing <i>Enterobacter</i> spp. Community Isolates in Belgrade, Serbia

Brkić, Snežana; Božić, Dragana; Stojanović, Nena; Vitorović, Teodora; Topalov, D; Jovanović, Mihajlo; Stepanović, Mladen; Ćirković, Ivana

doi:10.1089/mdr.2019.0224

Cited by 9 publications

(3 citation statements)

References 22 publications

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“…Although reports of CPE from Macedonia are missing, studies from neighboring countries reported concerning levels of NDM producers [31][32][33]. Therefore, the risk of importing CPE through the transfer of patients from these countries to those with a low prevalence is concerning.…”

Section: Discussionmentioning

confidence: 99%

A Patient With Multiple Carbapenemase Producers Including an Unusual Citrobacter sedlakii Hosting an IncC blaNDM-1- and armA-carrying Plasmid

Moser

Keller

Campos-Madueno

et al. 2021

PAI

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Background. Patients colonized with multiple species of carbapenemase-producing Enterobacterales (CPE) are increasingly observed. This phenomenon can be due to the high local prevalence of these pathogens, the presence of important host risk factors, and the great genetic promiscuity of some carbapenemase genes. Methods. We analyzed 4 CPE (Escherichia coli, Klebsiella pneumoniae, Providencia stuartii, Citrobacter sedlakii), 1 extended-spectrum cephalosporin-resistant K. pneumoniae (ESC-R-Kp), and 1 carbapenemase-producing Acinetobacter baumannii simultaneously isolated from a patient transferred from Macedonia. Susceptibility tests were performed using a microdilution MIC system. The complete genome sequences were obtained by using both short-read and long-read whole-genome sequencing technologies. Results. All CPE presented high-level resistance to all aminoglycosides due to the expression of the armA 16S rRNA methylase. In C. sedlakii and E. coli (ST69), both the carbapenemase blaNDM-1 and armA genes were located on an identical IncC plasmid of type 1a. The K. pneumoniae (ST268) and P. stuartii carried chromosomal blaNDM-1 and blaOXA-48, respectively, while the ESC-R-Kp (ST395) harbored a plasmid-located blaCTX-M-15. In the latter 3 isolates, armA-harboring IncC plasmids similar to plasmids found in C. sedlakii and E. coli were also detected. The A. baumannii strain possessed the blaOXA-40 carbapenemase gene. Conclusions. The characterization of the genetic organization of IncC-type plasmids harbored by 3 different species from the same patient offered insights into the evolution of these broad- host-range plasmids. Moreover, we characterized here the first complete genome sequence of a carbapenemase-producing C. sedlakii strain, providing a reference for future studies on this rarely reported species.

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Section: Discussionmentioning

confidence: 99%

A Patient With Multiple Carbapenemase Producers Including an Unusual Citrobacter sedlakii Hosting an IncC blaNDM-1- and armA-carrying Plasmid

Moser

Keller

Campos-Madueno

et al. 2021

PAI

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“…This means that for both species the appropriate treatment is still very uncertain and unspecific. 55.…”

Section: Possible Treatments For Enterobacter Sppmentioning

confidence: 99%

Systematic review: Mechanisms used by Klebsiella pneumoniae and Enterobacter spp to acquire their antibiotic multiresistant and what treatment alternatives exist.

Jimenez,

Dativa,

Moreno

2023

JER

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The management of infections of multiresistant bacterial etiology has become one of the biggest public health problems, both in financial costs and in the cost of human lives. 1 Within these infections, those produced by the Enterobacteriaceae family stand out, being representative Klebsiella pneumoniae and Enterobacter spp, which have a wide variety of mechanisms that give them the possibility of generating resistance to antibiotics; 2 therefore, there is no standardized treatment management that can be used in this type of infections, which have become a very important public health problem. Therefore, it is necessary to establish treatment alternatives that demonstrate greater efficacy. The purpose of this work then was to describe the mechanisms used by Klebsiella pneumoniae and Enterobacter spp. To acquire antibiotic multiresistant and what treatment alternatives exist for these cases.

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“…Resistance could be attributed to the different carbapenemases detected (Figure 4). blaNDM-1 was the most common (10/24), followed by blaOXA-181 (8/24), and blaOXA-48 (6/24), agreeing with Brkić et al, (2020).…”

Section: Chapter Four Discussionmentioning

confidence: 68%

Antibiotic Resistance, Virulence Factors and Whole-Genome Characterization of Enterobacter spp. and Klebsiella aerogenes isolated from hospitals in Lebanon. (c2022)

Ghafari¹

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Enterobacter cloacae complex (ECC) members and Klebsiella aerogenes are Gram-negative, rod-shaped, opportunistic pathogens that cause healthcare-associated infections and significantly threaten immunocompromised patients. Despite their clinical importance, their resistant profile and pathogenicity are not well understood due to the scarcity of studies in Lebanon and worldwide. This study presents a comprehensive whole-genome-based characterization of multidrug resistant and hypervirulent ECC members recovered from clinical settings in Lebanon. Identification and classification of 21 Enterobacter species and three K. aerogenes, was performed through hsp60 genotyping and 16S rRNA gene sequencing and confirmed by whole-genome average nucleotide identity (wgANI). Enterobacter spp. (N=21) were divided into three different genetic clusters: cluster VIII, cluster VI and only one members facilitated the exchange of resistance determinants. Co-selection of resistance and virulence characteristics could have provided a selective advantage. This study confirmed the polyphyletic nature of ECC members and their potential to rapidly evolve and adapt through horizontal gene transfer (HGT). It also revealed the need to expand prevention measures, showed the importance of developing and maintaining surveillance practices to control the spread of these pathogens, and the inevitability of implementing strict infection control measures in healthcare facilities. mapping to cluster XI. Multi-locus sequence typing (MLST) was used to determine the clonality of the isolates and core-genome single nucleotide polymorphism (SNP) to study the phylogenetic relatedness. MLST typing revealed the clonal diversity and helped in identifying epidemic clones such as ST114. Antibiotic susceptibility testing showed that most isolates were extensively drug-resistant (XDR), and the majority resistant to carbapenems(n=22/24). in silico analysis and plasmid-based replicon typing (PBRT) confirmed that the horizontal gene transfer of conjugative plasmids among ECC members facilitated the exchange of resistance determinants. Co-selection of resistance and virulence characteristics could have provided a selective advantage. This study confirmed the polyphyletic nature of ECC members and their potential to rapidly evolve and adapt through horizontal gene transfer (HGT). It also revealed the need to expand prevention measures, showed the importance of developing and maintaining surveillance practices to control the spread of these pathogens, and the inevitability of implementing strict infection control measures in healthcare facilities.

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Antimicrobial Susceptibility and Molecular Characterization of Carbapenemase-Producing Enterobacter spp. Community Isolates in Belgrade, Serbia

Cited by 9 publications

References 22 publications

A Patient With Multiple Carbapenemase Producers Including an Unusual Citrobacter sedlakii Hosting an IncC blaNDM-1- and armA-carrying Plasmid

A Patient With Multiple Carbapenemase Producers Including an Unusual Citrobacter sedlakii Hosting an IncC blaNDM-1- and armA-carrying Plasmid

Systematic review: Mechanisms used by Klebsiella pneumoniae and Enterobacter spp to acquire their antibiotic multiresistant and what treatment alternatives exist.

Antibiotic Resistance, Virulence Factors and Whole-Genome Characterization of Enterobacter spp. and Klebsiella aerogenes isolated from hospitals in Lebanon. (c2022)

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