Detection of P. aeruginosa harboring bla
CTX-M-2, bla
GES-1 and bla
GES-5,
bla
IMP-1 and bla
SPM-1causing infections in Brazilian tertiary-care hospital

Santi, Milena Polotto de; Casella, Tiago; Oliveira, Maria Gabriela de Lucca; Rubio, Fernando Gôngora; Nogueira, Maurício Lacerda; Almeida, Margarete Teresa Gottardo de; Nogueira, Mara Corrêa Lelles

doi:10.1186/1471-2334-12-176

Cited by 84 publications

(47 citation statements)

References 51 publications

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“…This new variant was identical to one found in Korea in Klebsiella pneumoniae isolates 19 . It is important to highlight that, as in other studies [22][23][24] , the present study did not detect a high occurrence of bla GES -positive P. aeruginosa isolates. Only four were found in a total of a hundred isolates, and two of these were clones, representing a low frequency of the gene.…”

Section: Discussioncontrasting

confidence: 52%

Detection of multidrug-resistant Pseudomonas aeruginosa harboring bla GES-1 and bla GES-11 in Recife, Brazil

Júnior

Ferreira

Alves

et al. 2017

Rev. Soc. Bras. Med. Trop.

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Introduction:Pseudomonas aeruginosa, an important pathogen globally, presents several resistance mechanisms. This study aimed to investigate the presence of bla GES in clinical isolates of Pseudomonas aeruginosa obtained from various clinical specimens from patients admitted to three different hospitals in Recife, Brazil. The Guiana extended spectrum beta-lactamase (GES) enzymes are responsible for conferring broad spectrum resistance to beta-lactam drugs, including the carbapenems. Methods: A total of 100 carbapenem-resistant P. aeruginosa isolates underwent polymerase chain reaction (PCR) testing to identify bla GES, bla KPC, bla SPM-1, bla IMP , and bla VIM . Additionally, PCR products positive for bla GES were sequenced. The clonal profi les of these same isolates were then determined by means of enterobacterial repetitive intergenic consensus (ERIC)-PCR analysis. Results: PCR analysis revealed that four isolates harbored bla GES ; DNA sequencing showed that two harbored bla GES-1 and two bla . Beta-lactamase genes bla SPM-1 , bla IMP , bla VIM , and bla KPC were investigated; none of these genes was detected. Automated susceptibility testing methods (Vitek®2, bioMérieux) showed that the bla GES-1 -positive isolates were only susceptible to polymyxin B. The patterns obtained with ERIC-PCR methods showed clonal relationship between the two isolates that harbored bla , whereas different clonal profi les were found in the isolates harboring bla GES-1. Conclusions: We detected the presence of bacterial isolates positive for two different variants of the enzyme GES in three different hospitals from Recife, Brazil. These enzymes have a great capacity for dissemination among Gram-negative bacteria and confer broad-spectrum resistance to betalactam antibiotics and to the carbapenems.

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Section: Discussioncontrasting

confidence: 52%

Detection of multidrug-resistant Pseudomonas aeruginosa harboring bla GES-1 and bla GES-11 in Recife, Brazil

Júnior

Ferreira

Alves

et al. 2017

Rev. Soc. Bras. Med. Trop.

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“…As reported in many epidemiological studies, P. aeruginosa clinical isolates are resistant to an increasingly wide variety of antibiotics, including "fourth-generation" cephalosporins. High levels of ␤-lactam resistance have been reported in the United States (6), Europe (7), and South America (8,9). In many cases, only colistin, and to some extent amikacin, still exhibits good activity against these multidrug-resistant P. aeruginosa infections (4).…”

mentioning

confidence: 99%

The Resistome of Pseudomonas aeruginosa in Relationship to Phenotypic Susceptibility

Kos

Déraspe

McLaughlin

et al. 2015

Antimicrob Agents Chemother

251

267

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Many clinical isolates of Pseudomonas aeruginosa cause infections that are difficult to eradicate due to their resistance to a wide variety of antibiotics. Key genetic determinants of resistance were identified through genome sequences of 390 clinical isolates of P. aeruginosa, obtained from diverse geographic locations collected between 2003 and 2012 and were related to microbiological susceptibility data for meropenem, levofloxacin, and amikacin. ␤-Lactamases and integron cassette arrangements were enriched in the established multidrug-resistant lineages of sequence types ST111 (predominantly O12) and ST235 (O11). This study demonstrates the utility of next-generation sequencing (NGS) in defining relevant resistance elements and highlights the diversity of resistance determinants within P. aeruginosa. This information is valuable in furthering the design of diagnostics and therapeutics for the treatment of P. aeruginosa infections.

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“…GES variants have already been described in association with other ␤-lactamases, such as carbapenemases like VIM, IMP, or OXA-23, especially in P. aeruginosa and in A. baumannii isolates (15)(16)(17). GES-1 and GES-5 were the two first GES variants identified in an epidemic P. aeruginosa clone ST235 in Spain (18).…”

mentioning

confidence: 99%

Spread of Plasmids Carrying Multiple GES Variants

Cuzon

Bogaerts

Bauraing

et al. 2016

Antimicrob Agents Chemother

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e Five GES-producing Enterobacteriaceae isolates that displayed an extended-spectrum ␤-lactamase (ESBL) phenotype harbored two GES variants: GES-7 ESBL and GES-6 carbapenemase. In all isolates, the two GES alleles were located on the same integron that was inserted into an 80-kb IncM1 self-conjugative plasmid. Whole-genome sequencing suggested in vivo horizontal gene transfer of the plasmid along with clonal diffusion of Enterobacter cloacae. To our knowledge, this is the first description in Europe of clustered Enterobacteriaceae isolates carrying two GES ␤-lactamases, of which one has extended activity toward carbapenems. GES-type extended-spectrum ␤-lactamases (ESBLs) are increasingly reported in Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae (1, 2, 3). More than 27 GES variants have now been identified throughout the world (3). One feature of these enzymes is that they may modify their spectrum of hydrolysis by point mutations. GES-2 was the first described example of an ESBL that extended its spectrum of activity against carbapenems through a single point mutation (4). To date, at least 12 variants possess a substitution at position 170 and are theoretically able to hydrolyze carbapenems. Some variants also have the ability to hydrolyze cefoxitin (GES-4, GES-5, GES-6, and GES-11) and/or aztreonam (GES-9 and GES-14) (3). The bla GES genes have been essentially described as gene cassettes associated with class 1 or class 3 integrons on plasmids with different types of replicases (3, 5).Here, we describe enterobacterial isolates recovered from a Belgian hospital that harbored two variants of bla GES genes that were inserted back to back in the same integron, one coding for an ESBL and the second one coding for a carbapenemase.In May 2007, an ESBL-producing Enterobacter cloacae isolate (EB-1) was isolated from the stool sample of a two-year-old girl who was hospitalized in the pediatric surgical ward of a Belgian hospital for a follow-up after a second liver transplantation. This patient underwent a first transplantation in Israel in January 2006 and was transferred to Belgium for a second transplantation. During initial hospitalization, all of the stool samples obtained for screening of ESBL carriage remained negative. The child left the hospital in May 2006 and did not travel until rehospitalization in May 2007. One week after the first case, an ESBL-producing Citrobacter youngae isolate (EB-2), displaying a similar resistance pattern, was cultured from the urine sample of a 1-year-old girl who was hospitalized for acute pyelonephritis in the same ward. A third child, a 3-year-old boy transferred from Macedonia for a liver transplant in November 2007, was negative for ESBL carriage at admission. He was found to be colonized with ESBL-producing Enterobacteriaceae in December 2007, first with an E. cloacae isolate (EB-3) and then with another E. cloacae isolate (EB-4) and a K. pneumoniae isolate (EB-5).Antibiograms performed by disk diffusion and interpreted accord...

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Detection of P. aeruginosa harboring bla CTX-M-2, bla GES-1 and bla GES-5, bla IMP-1 and bla SPM-1causing infections in Brazilian tertiary-care hospital

Cited by 84 publications

References 51 publications

Detection of multidrug-resistant Pseudomonas aeruginosa harboring bla GES-1 and bla GES-11 in Recife, Brazil

Detection of multidrug-resistant Pseudomonas aeruginosa harboring bla GES-1 and bla GES-11 in Recife, Brazil

The Resistome of Pseudomonas aeruginosa in Relationship to Phenotypic Susceptibility

Spread of Plasmids Carrying Multiple GES Variants

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