Carbapenemase-Encoding Genes and Colistin Resistance in Gram-Negative Bacteria During the COVID-19 Pandemic in Mexico: Results from the Invifar Network

Garza–Ramos, Ulises; Silva-Sánchez, Jesús; López‐Jácome, Luis Esaú; Hernández‐Durán, Melissa; Colín-Castro, Claudia Adriana; Sánchez-Pérez, Alejandro; Rodríguez-Santiago, Jonathan; Morfín‐Otero, Rayo; Rodríguez-Noriega, Eduardo; Velázquez-Acosta, María-Del-Consuelo; Vázquez-Larios, María del Rosario; Feliciano-Guzmán, José Manuel; Rojas‐Larios, Fabián; Ponce-de-León, Alfredo; Lozano-Garcia, Margarita; Choy-Chang, Elena Victoria; López-Gutiérrez, Eduardo; Molina-Jaimes, Aarón; Gil-Veloz, Mariana; Corte-Rojas, Reyna Edith; López-Ovilla, Ismelda; Ramirez-Mis, Jose Luis; Rodríguez-Balderas, Dora Elia; Molina-Chavarría, Alejandro; Padilla-Ibarra, Cecilia; Quevedo-Ramos, María Angelina; Mireles-Dávalos, Christian Daniel; Rodríguez-Medina, Nadia; Rubio-Mendoza, Daira; Córdova-Fletes, Carlos; Cruz-López, Flora; Becerra-Montejano, Dilva Angelina; Mercado-Longoría, Roberto; Martínez-Villarreal, Rebeca Thelma; Barlandas-Rendón, Nicolás Rogelio Eric; Mena-Ramírez, Juan Pablo; Couoh-May, Carlos Antonio; Alcaraz-Espejel, Margarita; Adame-Álvarez, Cesar; Hernández-Vicente, Lourdes; Garza‐González, Elvira

doi:10.1089/mdr.2022.0226

Cited by 12 publications

(17 citation statements)

References 74 publications

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“…The low prevalence of mcr genes found in this investigation among colistin-resistant strains (2/12) suggests that in our population, resistance to this agent might be mainly driven, as suggested by Gogry et al [26], by chromosomal mutations, such as those in the genes regulating the two-component systems, PhoPQ or PmrAB, or in its negatively regulating gene, mgrB, by mcr genes different from the mcr-1 to mcr-5 genes included in this investigation or by unknown colistin resistance mechanisms. The results of the current investigation are in agreement with those found in a recent report by Garza-Ramos et al who found that the more prevalent colistin-resistant mechanism in Mexico is not driven by mcr genes but by mgrB mutations [30]. Moreover, the low prevalence of mcr genes in our population might be partially explained by the fact that colistin-resistance in Enterobacterales has been linked mainly to mgrB mutations [35], rather than to plasmid-mediated genes.…”

Section: Discussionsupporting

confidence: 93%

“…The first mcr gene ( mcr -1) was originally described in 2015 in China [ 8 ], and in Mexico, mcr -1 was first identified in 2019 in an E. coli strain isolated from a fecal sample from a child [ 31 ]. The presence of this plasmid-mediated gene in our country was recently confirmed in K. pneumoniae strains isolated from different clinical samples [ 30 ]. In the present study, only two E. coli strains, both isolated from female patients with urinary tract infections that required hospitalization, were found to carry the mcr -1 gene and both strains were able to efficiently transfer this colistin-resistant determinant to recipient strains by means of an approximately 60 kb plasmid, as demonstrated by Southern blot analysis.…”

Section: Discussionmentioning

confidence: 77%

“…The prevalence of colistin resistance in this study is in agreement with reports in different geographical areas of the world among muti-drug-resistant strains isolated from hospitalized patients [ 10 , 27 , 28 ], but higher than the 1.26% worldwide prevalence reported by Dadashi et al [ 29 ]. In Mexico, reports on the prevalence of colistin-resistant strains are scarce; however, in a recent report by the Red Temática de Investigación y Vigilancia de la Farmacorresistencia (INVIFAR network), that included clinical strains isolated from different parts of the country, the colistin resistance prevalence among K. pneumoniae strains was 17.8% [ 30 ], a rate similar to that found in the current study among isolates of this bacterial species (3/20 = 15.0%). Unlike the INVIFAR report, where no resistance to colistin was found among E. coli strains, we found that 2.5% of the E. coli strains included in the current study presented this resistance trait.…”

Section: Discussionmentioning

confidence: 99%

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Detection of Plasmid-Mediated Resistance against Colistin in Multi-Drug-Resistant Gram-Negative Bacilli Isolated from a Tertiary Hospital

Galindo-Méndez,

Navarrete-Salazar,

Pacheco-Vásquez

et al. 2023

Microorganisms

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The aim of this study was to determine the prevalence of plasmid-mediated colistin resistance mcr-1 to mcr-5 genes among colistin and multi-drug-resistant Gram-negative bacilli strains isolated from patients in a tertiary hospital in Toluca, Mexico. The presence of mcr genes among the 241 strains collected was assessed by PCR. In the case of mcr-carrying E. coli, further PCR tests were performed to determine the presence of blaCTX-M and whether the strains belonged to the O25b-ST131 clone. Conjugation experiments were also carried out to assess the horizontal transmission of colistin resistance. A total of twelve strains (5.0%), of which four were E. coli; four were P. aeruginosa; three were K. pneumoniae, and one E. cloacae, were found to be resistant to colistin. Of these strains, two E. coli isolates were found to carry mcr-1, and Southern blot hybridization demonstrated its presence on an approximately 60 kb plasmid. Both mcr-1-carrying E. coli strains were found to co-express blaCTX-M, belong to the O25b-ST131 clone, and horizontally transmit their colistin resistance. The results of this study confirm the presence of plasmid-mediated colistin resistance in hospitalized patients in Mexico and demonstrated that the multi-drug-resistant O25b-ST131 E. coli clone can acquire mcr genes and transmit such resistance traits to other bacteria.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

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Detection of Plasmid-Mediated Resistance against Colistin in Multi-Drug-Resistant Gram-Negative Bacilli Isolated from a Tertiary Hospital

Galindo-Méndez,

Navarrete-Salazar,

Pacheco-Vásquez

et al. 2023

Microorganisms

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“…In this study, the primary mechanism of colistin-resistant isolates was modifications in the mgrB gene, and the main carbapenemase was NDM-1. Unlike the panorama in different regions of Latin America, a recent study carried out in Mexico showed that the NDM-type carbapenemases were more frequent than KPC-type 17 . Thus, we consider that Mexico is New-Delhi metallo-β-lactamase territory.…”

Section: Discussionmentioning

confidence: 92%

Comprehensive study reveals phenotypic heterogeneity in Klebsiella pneumoniae species complex isolates

Rodríguez-Medina,

Rodríguez-Santiago,

Alvarado-Delgado

et al. 2024

Sci Rep

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Here, we conducted a comprehensive analysis of 356 Klebsiella pneumoniae species complex (KpSC) isolates that were classified as classical (cl), presumptive hypervirulent (p-hv) and hypermucoviscous-like (hmv-like). Overall, K. pneumoniae (82.3%), K. variicola (2.5%) and K. quasipneumoniae (2.5%) were identified. These isolates comprised 321 cl-KpSC, 7 p-hv-KpSC and 18 hmv-like-KpSC. A large proportion of cl-KpSC isolates were extended-spectrum-β-lactamases (ESBLs)-producers (64.4%) and 3.4% of isolates were colistin-resistant carrying carbapenemase and ESBL genes. All p-hv-KpSC showed an antibiotic susceptible phenotype and hmv-like isolates were found to be ESBL-producers (8/18). Assays for capsule production and capsule-dependent virulence phenotypes and whole-genome sequencing (WGS) were performed in a subset of isolates. Capsule amount differed in all p-hv strains and hmv-like produced higher capsule amounts than cl strains; these variations had important implications in phagocytosis and virulence. Murine sepsis model showed that most cl strains were nonlethal and the hmv-like caused 100% mortality with 3 × 108 CFUs. Unexpectedly, 3/7 (42.9%) of p-hv strains required 108 CFUs to cause 100% mortality (atypical hypervirulent), and 4/7 (57.1%) strains were considered truly hypervirulent (hv). Genomic analyses confirmed the diverse population, including isolates belonging to hv clonal groups (CG) CG23, CG86, CG380 and CG25 (this corresponded to the ST3999 a novel hv clone) and MDR clones such as CG258 and CG147 (ST392) among others. We noted that the hmv-like and hv-ST3999 isolates showed a close phylogenetic relationship with cl-MDR K. pneumoniae. The information collected here is important to understand the evolution of clinically important phenotypes such as hypervirulent and ESBL-producing-hypermucoviscous-like amongst the KpSC in Mexican healthcare settings. Likewise, this study shows that mgrB inactivation is the main mechanism of colistin resistance in K. pneumoniae isolates from Mexico.

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“…As part of the active surveillance performed by the INVIFAR network, centers sent relevant carbapenem-resistant Gram negatives to the coordinating laboratory. In the clinical isolates received from centers, polymerase chain reaction (PCR) was performed to detect the most frequent carbapenemase-encoding genes previously reported in this population [ 15 ], that is, bla NDM-1 , bla KPC , bla VIM , bla IMP , and bla OXA-48-like [ 16 , 17 ] in E. coli and K. pneumoniae isolates; bla OXA-23 and bla OXA-24 in A. baumannii isolates [ 18 , 19 ]; and bla VIM , bla IMP , and bla GES in P. aeruginosa isolates [ 10 ].…”

Section: Methodsmentioning

confidence: 99%

Active Surveillance of Antimicrobial Resistance and Carbapenemase-Encoding Genes According to Sites of Care and Age Groups in Mexico: Results from the INVIFAR Network

Rojas-Larios,

Martínez-Guerra,

López-Jácome

et al. 2023

Pathogens

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We analyzed the antimicrobial resistance (AMR) data of 6519 clinical isolates of Escherichia coli (n = 3985), Klebsiella pneumoniae (n = 775), Acinetobacter baumannii (n = 163), Pseudomonas aeruginosa (n = 781), Enterococcus faecium (n = 124), and Staphylococcus aureus (n = 691) from 43 centers in Mexico. AMR assays were performed using commercial microdilution systems (37/43) and the disk diffusion susceptibility method (6/43). The presence of carbapenemase-encoding genes was assessed using PCR. Data from centers regarding site of care, patient age, and clinical specimen were collected. According to the site of care, the highest AMR was observed in E. coli, K. pneumoniae, and P. aeruginosa isolates from ICU patients. In contrast, in A. baumannii, higher AMR was observed in isolates from hospitalized non-ICU patients. According to age group, the highest AMR was observed in the ≥60 years age group for E. coli, E. faecium, and S. aureus, and in the 19–59 years age group for A. baumannii and P. aeruginosa. According to clinical specimen type, a higher AMR was observed in E. coli, K. pneumoniae, and P. aeruginosa isolates from blood specimens. The most frequently detected carbapenemase-encoding gene in E. coli was blaNDM (84%).

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Carbapenemase-Encoding Genes and Colistin Resistance in Gram-Negative Bacteria During the COVID-19 Pandemic in Mexico: Results from the Invifar Network

Cited by 12 publications

References 74 publications

Detection of Plasmid-Mediated Resistance against Colistin in Multi-Drug-Resistant Gram-Negative Bacilli Isolated from a Tertiary Hospital

Detection of Plasmid-Mediated Resistance against Colistin in Multi-Drug-Resistant Gram-Negative Bacilli Isolated from a Tertiary Hospital

Comprehensive study reveals phenotypic heterogeneity in Klebsiella pneumoniae species complex isolates

Active Surveillance of Antimicrobial Resistance and Carbapenemase-Encoding Genes According to Sites of Care and Age Groups in Mexico: Results from the INVIFAR Network

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