Genetic Relatedness of NDM-Producing <i>Klebsiella pneumoniae</i> Co-Occurring VIM, KPC, and OXA-48 Enzymes from Surveillance Cultures from an Intensive Care Unit

Flores, Claudia; Bianco, Kayo; Filippis, Ivano de; Clementino, Maysa M.; Romão, Célia Maria Carvalho Pereira Araújo

doi:10.1089/mdr.2019.0483

Cited by 13 publications

(11 citation statements)

References 81 publications

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“…Approximately one-third of the isolates received at this center (27.0%—52/196) were co-producers, with a combination of serine and MβLs, of which 60% had a combination of KPC and NDM [ 49 ]. In Brazil, the presence of over 20 bla NDM and bla KPC K. pneumoniae co-producing isolates, distributed among the Northeast, Southeast and South regions, have been described [ 12 , 15 , 27 , 31 , 50 ]. In the present study, four CR-Kp isolates were detected co-harboring bla NDM and bla KPC .…”

Section: Discussionmentioning

confidence: 99%

“…However, it has demonstrated a concerning spread, with strains particularly harboring the bla NDM gene and rarely associated with bla KPC [ 54 , 61 ]. Since its first report in Brazil by Gonçalves et al [ 17 ], ST15/CC15 has been detected in clinical and environmental samples, but with few reported NDM-producing strains in Porto Alegre (South region), Rio de Janeiro (Southeast), and Brasilia (Midwest region) cities [ 9 , 50 , 54 , 62 ]. According to our data, NDM-producing ST15/CC15 strains have been found circulating in four different hospitals since 2018 and mostly present adult settings, suggesting an early and rapid spread across Brazil.…”

Section: Discussionmentioning

confidence: 99%

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The Spread of NDM-1 and NDM-7-Producing Klebsiella pneumoniae Is Driven by Multiclonal Expansion of High-Risk Clones in Healthcare Institutions in the State of Pará, Brazilian Amazon Region

et al. 2021

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Carbapenem resistance among Klebsiella pneumoniae isolates is often related to carbapenemase genes, located in genetic transmissible elements, particularly the blaKPC gene, which variants are spread in several countries. Recently, reports of K. pneumoniae isolates harboring the blaNDM gene have increased dramatically along with the dissemination of epidemic high-risk clones (HRCs). In the present study, we report the multiclonal spread of New Delhi metallo-beta-lactamase (NDM)-producing K. pneumoniae in different healthcare institutions in the state of Pará, Northern Brazil. A total of 23 NDM-producing isolates were tested regarding antimicrobial susceptibility testing features, screening of carbapenemase genes, and genotyping by multilocus sequencing typing (MLST). All K. pneumoniae isolates were determined as multidrug-resistant (MDR), being mainly resistant to carbapenems, cephalosporins, and fluoroquinolones. The blaNDM-7 (60.9%—14/23) and blaNDM-1 (34.8%—8/23) variants were detected. MLST genotyping revealed the predomination of HRCs, including ST11/CC258, ST340/CC258, ST15/CC15, ST392/CC147, among others. To conclude, the present study reveals the contribution of HRCs and non-HRCs in the spread of NDM-1 and NDM-7-producing K. pneumoniae isolates in Northern (Amazon region) Brazil, along with the first detection of NDM-7 variant in Latin America and Brazil, highlighting the need for surveillance and control of strains that may negatively impact healthcare and antimicrobial resistance.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Spread of NDM-1 and NDM-7-Producing Klebsiella pneumoniae Is Driven by Multiclonal Expansion of High-Risk Clones in Healthcare Institutions in the State of Pará, Brazilian Amazon Region

et al. 2021

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“…A coexistência dos genes blaNDM-5 e blaOXA-181 já foram identificados em um hospital terciário da Coréia em isolados de E coli (Baek et al, 2019). No Brasil, culturas ativas de vigilância de pacientes de UTI de um hospital do Rio de Janeiro, co-abrigava até quatro carbapenemases NDM, KPC, OXA-48 e VIM (Flores et al, 2020). Em P. mirabilis e S. marcescens foi descrito a associação de blaNDM-1 e blaKPC-2 em Pernambuco, Brasil (Firmo et al, 2020).…”

Section: Discussionunclassified

Epidemiologia molecular de bacilos Gram-negativos multidroga resistente produtores de carbapenemases isoladas de diferentes sítios de infecção

Soares

Silva

Júnior

et al. 2021

RSD

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A resistência a carbapenemases em bacilos gram-negativas (BGN) tornou-se um problema mundial, elevando a taxa de morbidade e mortalidade. O método automatizado foi utilizado para identificação e suscetibilidade dos isolados. E o método molecular foi aplicado na detecção de bacilos gram-negativas (BGN) produtoras de carbapenemase. Um total de 205 BGN foram recuperados a partir de diferentes amostras clínicas, resistentes a carbapenemases. Os genes de resistência blaKPC (57,5%), blaVIM (30,2%), blaGES (17%), blaNDM (15%) e blaSPM (2,4%) foram recuperados a partir de isolados clínicos. O gene blaIMP não foi detectado em nenhum dos isolados. É preocupante que Pseudomonas aeruginosa e Acinetobacter baumannii representem a maioria dos isolados (61,6%) recuperados de infecções de diferentes sítios, com alta resistência a carbapenêmicos, carregando simultaneamente os genes blaKPC, blaGES e blaVIM, assim como encontrados também em Enterobactericeae. A carbapenemase mais prevalente foi blaKPC e blaVIM, seguida de blaNDM dentre os isolados multidroga resistentes. Esses resultados são um ameaça à saúde pública, configurando altas taxas de resistência, limitando as opções terapêuticas.

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“…VIM-type enzymes are widely detected in Italy and in Europe [39,40], harbored predominantly on IncN plasmids [6,7]. The expression of a VIM-1 enzyme by a high-risk ST69 clone, can represent a challenge, limiting the therapeutic options.…”

Section: Discussionmentioning

confidence: 99%

Genomic Insight of VIM-harboring IncA Plasmid from a Clinical ST69 Escherichia coli Strain in Italy

et al. 2020

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Background: VIM (Verona Integron-encoded Metallo-beta-lactamase) is a member of the Metallo-Beta-Lactamases (MBLs), and is able to hydrolyze all beta-lactams antibiotics, except for monobactams, and including carbapenems. Here we characterize a VIM-producing IncA plasmid isolated from a clinical ST69 Escherichia coli strain from an Italian Long-Term Care Facility (LTCF) inpatient. Methods: An antimicrobial susceptibility test and conjugation assay were carried out, and the transferability of the blaVIM-type gene was confirmed in the transconjugant. Whole-genome sequencing (WGS) of the strain 550 was performed using the Sequel I platform. Genome assembly was performed using “Microbial Assembly”. Genomic analysis was conducted by uploading the contigs to ResFinder and PlasmidFinder databases. Results: Assembly resulted in three complete circular contigs: the chromosome (4,962,700 bp), an IncA plasmid (p550_IncA_VIM_1; 162,608 bp), harboring genes coding for aminoglycoside resistance (aac(6′)-Ib4, ant(3″)-Ia, aph(3″)-Ib, aph(3′)-XV, aph(6)-Id), beta-lactam resistance (blaSHV-12, blaVIM-1), macrolides resistance (mph(A)), phenicol resistance (catB2), quinolones resistance (qnrS1), sulphonamide resistance (sul1, sul2), and trimethoprim resistance (dfrA14), and an IncK/Z plasmid (p550_IncB_O_K_Z; 100,306 bp), free of antibiotic resistance genes. Conclusions: The increase in reports of IncA plasmids bearing different antimicrobial resistance genes highlights the overall important role of IncA plasmids in disseminating carbapenemase genes, with a preference for the blaVIM-1 gene in Italy.

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Genetic Relatedness of NDM-Producing Klebsiella pneumoniae Co-Occurring VIM, KPC, and OXA-48 Enzymes from Surveillance Cultures from an Intensive Care Unit

Cited by 13 publications

References 81 publications

The Spread of NDM-1 and NDM-7-Producing Klebsiella pneumoniae Is Driven by Multiclonal Expansion of High-Risk Clones in Healthcare Institutions in the State of Pará, Brazilian Amazon Region

The Spread of NDM-1 and NDM-7-Producing Klebsiella pneumoniae Is Driven by Multiclonal Expansion of High-Risk Clones in Healthcare Institutions in the State of Pará, Brazilian Amazon Region

Epidemiologia molecular de bacilos Gram-negativos multidroga resistente produtores de carbapenemases isoladas de diferentes sítios de infecção

Genomic Insight of VIM-harboring IncA Plasmid from a Clinical ST69 Escherichia coli Strain in Italy

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