Introduction of NDM-1 and OXA-370 from Brazil into Chile in strains of Klebsiella pneumoniae isolated from a single patient

Abstract

Carbapenemase-producing Enterobacteriaceae have rapidly disseminated worldwide and can colonize patients in healthcare centers. As in Chile the first isolations of NDM-1 and OXA-370 carbapenemases were related with a patient arriving from Brazil, the genetic relatedness of Klebsiella pneumoniae strains producers of these enzymes and isolated in both countries was assessed. PFGE analyses revealed that the isolates were clonally related, illustrating how travel contributes to the spread of multidrug-resistant microorganisms. In addition, the occurrence of three different carbapenemases in three different K. pneumoniae strains isolated from a single patient is described.

Evaluation of MASTDISCS combi Carba plus for the identification of metallo‐β‐lactamases, KPC and OXA‐48 carbapenemase genes in Enterobacteriaceae clinical isolates

“…Carbapenems are often considered last resort antibiotics in the treatment of infections due to multidrug-resistant Enterobacteriaceae clinical isolates, since they are stable even in response to extended-spectrum b-lactamases (ESBLs) and AmpC enzymes (Tsakris et al 2010;Jean et al 2018;Carrasco-Anabal on et al 2019;Wang et al 2019). However, the carbapenem resistance has been increasingly reported among Enterobacteriaceae in the past few years, which is largely attributed to the production of metallo-b-lactamases (MBLs), KPC and OXA-48 (Yusuf et al 2014;Tijet et al 2016;No€ el et al 2017;Tamma and Simner 2018).…”

Carbapenemasas en aislamientos de Pseudomonas aeruginosa resistentes a carbapenémicos aisladas en hospitales de Chile

“…En general esta prueba fenotípica tiene un elevado rendimiento con una sensibilidad y especificidad de 98% cuando se estudió en P. aeruginosa 26 , como también se observó en este trabajo, y tiene un rendimiento más bajo en A. baumannii, por la producción de carbapenemasas del grupo OXA, que ha ido mejorando con diferentes variantes del método. En general, el mayor problema es la detección de OXA-48 que epidemiológicamente es importante en Enterobacterales en España 27 , por ejemplo, pero poco informada hasta ahora en Chile 28 .…”

Novel Megaplasmid Driving NDM-1-Mediated Carbapenem Resistance in Klebsiella pneumoniae ST1588 in South America

“…A carbapenem-resistant K. pneumoniae strain, UCO-361, that corresponds to the first NDM-1-carrying strain detected in Chile, was analyzed. UCO-361 was recovered from a rectal swab of a colonized inpatient in a public hospital in Santiago (Capital of Chile) and is genetically related to a Brazilian clone [ 7 ]. This isolate was recovered from a hospitalized patient that shared a room with a colonized patient who was previously hospitalized in Brazil [ 7 ].…”

“…UCO-361 was recovered from a rectal swab of a colonized inpatient in a public hospital in Santiago (Capital of Chile) and is genetically related to a Brazilian clone [ 7 ]. This isolate was recovered from a hospitalized patient that shared a room with a colonized patient who was previously hospitalized in Brazil [ 7 ]. Moreover, Escherichia coli J53 (sodium-azide-resistant strain, SAZ R ) was used as a recipient strain for mating experiments.…”

“…In this sense, the Reference Laboratory of Healthcare-Associated Infections (HAIs) of the Instituto de Salud Pública de Chile (ISP, Chile) confirmed the first isolation of the K. pneumoniae producer of NDM-1 in Chile in May 2014 ( , accessed on 5 March 2022). Importantly, we previously determined that this isolate, named UCO-361, was genetically related to an NDM-producer K. pneumoniae collected in Brazil, revealing the importance of genomic surveillance [ 7 ]. After their first identification, 84 NDM-producing Gram-negative isolates were reported during the 2014–2017 period in Chile ( , accessed on 5 March 2022), which demonstrates that these enzymes are circulating in the country at an unknown frequency.…”