Drug resistance phenotypes and genotypes in Mexico in representative gram-negative species: Results from the infivar network

Abstract

Aim This report presents phenotypic and genetic data on the prevalence and characteristics of extended-spectrum β-lactamases (ESBLs) and representative carbapenemases-producing Gram-negative species in Mexico. Material and methods A total of 52 centers participated, 43 hospital-based laboratories and 9 external laboratories. The distribution of antimicrobial resistance data for Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, Acinetobacter baumannii complex, and Pseudomonas aeruginosa in selected clinical specimens from January 1 to March 31, 2020 was analyzed using the WHONET 5.6 platform. The following clinical isolates recovered from selected specimens were included: carbapenem-resistant Enterobacteriaceae, ESBL or carbapenem-resistant E. coli, and K. pneumoniae, carbapenem-resistant A. baumannii complex, and P. aeruginosa. Strains were genotyped to detect ESBL and/or carbapenemase-encoding genes. Results Among blood isolates, A. baumannii complex showed more than 68% resistance for all antibiotics tested, and among Enterobacteria, E. cloacae complex showed higher resistance to carbapenems. A. baumannii complex showed a higher resistance pattern for respiratory specimens, with only amikacin having a resistance lower than 70%. Among K. pneumoniae isolates, blaTEM, blaSHV, and blaCTX were detected in 68.79%, 72.3%, and 91.9% of isolates, respectively. Among E. coli isolates, blaTEM, blaSHV, and blaCTX were detected in 20.8%, 4.53%, and 85.7% isolates, respectively. For both species, the most frequent genotype was blaCTX-M-15. Among Enterobacteriaceae, the most frequently detected carbapenemase-encoding gene was blaNDM-1 (81.5%), followed by blaOXA-232 (14.8%) and blaoxa-181(7.4%), in A. baumannii was blaOXA-24 (76%) and in P. aeruginosa, was blaIMP (25.3%), followed by blaGES and blaVIM (13.1% each). Conclusion Our study reports that NDM-1 is the most frequent carbapenemase-encoding gene in Mexico in Enterobacteriaceae with the circulation of the oxacillinase genes 181 and 232. KPC, in contrast to other countries in Latin America and the USA, is a rare occurrence. Additionally, a high circulation of ESBL blaCTX-M-15 exists in both E. coli and K. pneumoniae.

ESKAPE bacteria characterization reveals the presence of Acinetobacter baumannii and Pseudomonas aeruginosa outbreaks in COVID-19/VAP patients

“…We detected isolates with resistance to tested antimicrobials, mainly β−lactams and other agents used in VAP patients, such as aminoglycosides and fluoroquinolones 56 ( Table 3 ). Resistance profiles similar to those of this work have been observed in other studies 51 , 57 , 58 . The background of the presence of one of the main mechanisms of antimicrobial resistance in A. baumannii 59 , 60 , a genetic and phenotypic search for efflux pumps in this pathogen was performed, although PCR tests demonstrated the presence of the complete AdeABCRS operon, pump inhibition tests did not demonstrate its activity.…”

Point Prevalence Survey of Antimicrobial Use in Four Tertiary Care Hospitals in Mexico

“…34 All the above could represent a common scenario associated to the recurrent identification of MDR E. coli and ESKAPE pathogens in the hospitals surveyed, as well as in other Mexican hospitals. 16,17,35,36 We consider that our findings could be partly explained by the absence of formally established ASPs in the hospitals surveyed. ASPs consist of a variety of systematic activities and interventions aimed to optimize the antimicrobial use.…”

“…All the above could represent a common scenario associated to the recurrent identification of MDR E. coli and ESKAPE pathogens in the hospitals surveyed, as well as in other Mexican hospitals. 16 , 17 , 35 , 36 …”

A case–control study of infections caused by Klebsiella pneumoniae producing New Delhi metallo-beta-lactamase-1: Predictors and outcomes

“…In the third investigation, phenotypic and genetic data were analyzed. Among Enterobacterales, the most frequently detected carbapenemase-encoding gene was bla NDM-1 (81.5%), followed by bla OXA-232 (14.8%) and blaOXA-181 (7.4%); that in A. baumannii was bla OXA-24 (76%) and that in P. aeruginosa was bla IMP (25.3%), followed by bla GES and bla VIM (13.1% each) ( Garza-Gonzalez et al., 2021 ).…”