Association of blaNDM-1 with blaKPC-2 and aminoglycoside-modifying enzyme genes among Klebsiella pneumoniae, Proteus mirabilis and Serratia marcescens clinical isolates in Brazil

Firmo, Elza Ferreira; Beltrão, Elizabeth Maria Bispo; Silva, Felipe Rogério Ferreira da; Alves, Luiz Cláudio Pinto de Sá; Brayner, Fábio André; Veras, Dyana Leal; Lópes, Ana Catarina de Souza

doi:10.1016/j.jgar.2019.08.026

Cited by 46 publications

(37 citation statements)

References 36 publications

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“…Indeed P. mirabilis is naturally resistant to polymyxins, one of the only drugs showing some efficacy against KPC-producers. However, this discovery is not entirely unexpected, given the number of publications reporting the spread of the bla KPC genes between different Gram-negative bacterial species such as K. pneumoniae and P. aeruginosa in the same hospital (Recife, Brazil) (Cabral et al, 2015).…”

Section: Acc-1mentioning

confidence: 98%

“…), including ESBLs genes such as bla VEB−1 (Naas et al, 2000;Kim et al, 2004) even simultaneously associated with carbapenemases genes such as bla VIM−1 (Papagiannitsis et al, 2012). a Wild type P. mirabilis CIP103181 (Girlich et al, 2017), restricted-spectrum penicillinase TEM-1 in P. mirabilis CF19 (de Champs et al, 2000); extended-spectrum β-lactamase (BLSE) TEM-3 in P. mirabilis PSM1-5 (Mariotte et al, 1994); TEM-52 in P. mirabilis DG6499 (Tonkic et al, 2010) and P. mirabilis PM685 (Luzzaro et al, 2001); CTX-M-2 in P. mirabilis TUM4653 (Harada et al, 2012) and P. mirabilis PM15SM02 (Pagani et al, 2003); IRT (TEM-67) in P. mirabilis NEL (Naas et al, 2003); plasmid-encoded cephalosporinase CMY-2 in P. mirabilis TUM4660 (Harada et al, 2010), CMY-3 (+TEM-2) in P. mirabilis CF09 (Bret et al, 1998) and ACC-1 in P. mirabilis SPI-1 (Girlich et al, 2000a); carbapenemases KPC-2 in P. mirabilis from China (Hu et al, 2012) and Brazil (Cabral et al, 2015); NDM-1 (+VEB-6) in P. mirabilis PEL (Girlich et al, 2015); OXA-48 (+CTX-M-14 + TEM-1) in P. mirabilis Pm-OXA-48 (Chen et al, 2015); OXA-23 in P. mirabilis CF0239 (Bonnet et al, 2002) and OXA-58 in P. mirabilis 1091 (Girlich et al, 2017 Other ESBLs such as CTX-M-15, SHV-12, TEM-28 or carbapenemases such as NDM-1 have also been described in P. mirabilis (Dortet et al, 2012).…”

Section: Narrow Spectrum Oxacillinasesmentioning

confidence: 99%

“…In P. mirabilis, KPC-2 was identified for the first time in 2008 in the blood culture of a diabetic patient in the United States (Tibbetts et al, 2008). Then, KPC-2 producing P. mirabilis isolates have been identified in China (Shen et al, 2009;Sheng et al, 2010;Hu et al, 2012), Colombia (Cuzon et al, 2011)Brazil (Cabral et al, 2015), and Italy (Di Pilato et al, 2016). The bla KPC−2 gene was located on 45-54 kb conjugative plasmids, surrounded by ISKpn8 and ISKpn6-like, as the structure described in K. pneumoniae KP048 (Shen et al, 2009) (Figure 3).…”

Section: Acc-1mentioning

confidence: 99%

“…Prevalence of carbapenemases in P. mirabilis is still low, nevertheless, it tends to increase over time worldwide. KPC-2 carbapenemase in P. mirabilis was first reported in the United States in 2008 (Tibbetts et al, 2008), and then in a few studies from China 2010 (Sheng et al, 2010) and Brazil 2015 (Cabral et al, 2015). The acquisition of metallo-b-lactamase genes such as bla VIM−like genes emerged in Greece in 2006 (Vourli et al, 2006) in Italy in 2008 and more recently in Bulgaria (Markovska et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

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Genetics of Acquired Antibiotic Resistance Genes in Proteus spp.

2020

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Proteus spp. are commensal Enterobacterales of the human digestive tract. At the same time, P. mirabilis is commonly involved in urinary tract infections (UTI). P. mirabilis is naturally resistant to several antibiotics including colistin and shows reduced susceptibility to imipenem. However higher levels of resistance to imipenem commonly occur in P. mirabilis isolates consecutively to the loss of porins, reduced expression of penicillin binding proteins (PBPs) PBP1a, PBP2, or acquisition of several antibiotic resistance genes, including carbapenemase genes. In addition, resistance to nonβ-lactams is also frequently reported including molecules used for treating UTI infections (e.g., fluoroquinolones, nitrofurans). Emergence and spread of multidrug resistant P. mirabilis isolates, including those producing ESBLs, AmpC cephalosporinases and carbapenemases, are being more and more frequently reported. This review covers Proteus spp. with a focus on the different genetic mechanisms involved in the acquisition of resistance genes to multiple antibiotic classes turning P. mirabilis into a dreadful pandrug resistant bacteria and resulting in difficult to treat infections.

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Section: Acc-1mentioning

confidence: 98%

Section: Narrow Spectrum Oxacillinasesmentioning

confidence: 99%

Section: Acc-1mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Genetics of Acquired Antibiotic Resistance Genes in Proteus spp.

2020

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“…Klebsiella pneumoniae carbapenemase (KPC) has become endemic in several countries and is frequently detected in K. pneumoniae isolates from Brazilian hospitals 1,13,14,15,16,17 . The bla KPC gene is often located on the transposon Tn4401 (Eilertson et al 18 ), which has been found in several transferable plasmids 4,19,20 , which ensures its dispersion among Klebsiella species and other genera of Gram-negative bacteria (Belder et al 21 ).…”

Section: Introductionmentioning

confidence: 99%

High plasmid variability, and the presence of IncFIB, IncQ, IncA/C, IncHI1B, and IncL/M in clinical isolates of Klebsiella pneumoniae with bla KPC and bla NDM from patients at a public hospital in Brazil.

Oliveira

Beltrão

Scavuzzi

et al. 2020

Rev. Soc. Bras. Med. Trop.

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Introduction: Antibiotic resistance in carbapenemase-producing Klebsiella pneumoniae is acquired and disseminated mainly by plasmids. Therefore, we aimed to investigate the occurrence of carbapenemase genes, analyze the genetic diversity by ERIC-PCR, and examine the most common plasmid incompatibility groups (Incs) in clinical isolates of K. pneumoniae from colonization and infection in patients from a hospital in Brazil. Methods: Twenty-seven isolates of carbapenem-resistant K. pneumoniae were selected and screened for the presence of carbapenemase genes and Incs by PCR, followed by amplicon sequencing. Results: The bla KPC and bla NDM genes were detected in 24 (88.8 %) and 16 (59.2 %) of the isolates, respectively. Thirteen isolates (48.1 %) were positive for both genes. The IncFIB (92.6 %) and IncQ (88.8 %) were the most frequent plasmids, followed by IncA/C, IncHI1B, and IncL/M, indicating that plasmid variability existed in these isolates. To our knowledge, this is the first report of IncHI1B in Brazil. We found eight isolates with clonal relationship distributed in different sectors of the hospital. Conclusions: The accumulation of resistance determinants, the variability of plasmid Incs, and the clonal dissemination detected in K. pneumoniae isolates demonstrate their potential for infection, colonization, and the dissemination of different resistance genes and plasmids.

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Emergence of carbapenem‐resistant Klebsiella pneumoniae species complex from agrifood systems: detection of ST6326 co‐producing KPC‐2 and NDM‐1

Furlan,

da Silva Rosa,

Ramos

et al. 2024

J Sci Food Agric

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BackgroundKlebsiella pneumoniae species complex (KpSC) is an important disseminator of carbapenemase‐encoding genes, mainly blaKPC‐2 and blaNDM‐1, from hospitals to the environment. Consequently, carbapenem‐resistant strains can be spread through the agrifood system, raising concerns about food safety. Therefore, this study aimed to isolate carbapenem‐resistant KpSC strains from agricultural and environmental sectors and characterize them by phenotypic, molecular, and genomic analyses.ResultsK. pneumoniae and Klebsiella quasipneumoniae strains isolated from soils with lemon, guava, and fig cultivation, and surface waters displayed an extensive drug resistance profile and carried blaKPC‐2, blaNDM‐1, or both. In addition to carbapenemase‐encoding genes, KpSC strains harbor a broad resistome (antimicrobial resistance and metal tolerance) and present putative hypervirulence. Soil‐derived K. pneumoniae strains were assigned as high‐risk clones (ST11 and ST307) and harbored the blaKPC‐2 gene associated with Tn4401b and Tn3‐like elements on IncN‐pST15 and IncX5 plasmids. In surface waters, the coexistence of blaKPC‐2 and blaNDM‐1 genes was identified in the K. pneumoniae ST6326, a new carbapenem‐resistant regional Brazilian clone. In this case, blaKPC‐2 with Tn4401a isoform and blaNDM‐1 associated with a Tn125‐like transposon were located on different plasmids. In addition, K. quasipneumoniae ST526 presented the blaNDM‐1 gene associated with a Tn3000 transposon on an IncX3 plasmid.ConclusionThese findings alert for the transmission of carbapenemase‐positive KpSC across the agricultural and environmental sectors, raising critical food safety and environmental issues.This article is protected by copyright. All rights reserved.

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Association of blaNDM-1 with blaKPC-2 and aminoglycoside-modifying enzyme genes among Klebsiella pneumoniae, Proteus mirabilis and Serratia marcescens clinical isolates in Brazil

Cited by 46 publications

References 36 publications

Genetics of Acquired Antibiotic Resistance Genes in Proteus spp.

Genetics of Acquired Antibiotic Resistance Genes in Proteus spp.

High plasmid variability, and the presence of IncFIB, IncQ, IncA/C, IncHI1B, and IncL/M in clinical isolates of Klebsiella pneumoniae with bla KPC and bla NDM from patients at a public hospital in Brazil.

Emergence of carbapenem‐resistant Klebsiella pneumoniae species complex from agrifood systems: detection of ST6326 co‐producing KPC‐2 and NDM‐1

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