Nueva descripción en España de un portador de Klebsiella pneumoniae productora de una carbapenemasa NDM-1

Romero, Yolanda; Sanz-Rodríguez, Nuria; Almagro-Moltó, María; Gómez-Garcés, José Luís

doi:10.1016/j.eimc.2012.10.009

Cited by 10 publications

(2 citation statements)

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“…Previous isolates carried the NDM-1 variant and were associated with recent travels to India (6,23,24), while HC105 represents the first NDM-5 reported in Spain, and it was recovered from a nontraveler whose close relatives reported no recent traveling history either, thus suggesting that it was community acquired and autochthonous. This is also the first ST448 E. coli strain harboring an NDM enzyme.…”

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Molecular Characterization of bla _NDM-5 Carried on an IncFII Plasmid in an Escherichia coli Isolate from a Nontraveler Patient in Spain

Pitart

Solé

Roca

et al. 2015

Antimicrob Agents Chemother

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A carbapenem-resistant Escherichia coli isolate (sequence type 448 [ST448]) was recovered from a urine culture of a female patient with no recent record of traveling. PCR screening identified the presence of bla NDM-5 , bla TEM-1 , bla OXA-1 , bla CMY-42 , and rmtB. bla NDM-5 was carried in a conjugative IncFII-type plasmid (90 kb) together with bla TEM-1 and rmtB. The genetic environment of bla NDM-5 showed a structure similar to those of pMC-NDM and pGUE-NDM, identified in Poland and France in E. coli of African and Indian origin, respectively. C arbapenemase-producing Enterobacteriaceae (CPE) constitute a public health problem regarding both hospital-and community-acquired infections (1). Despite increasing reports of CPE in Europe, predominantly in southern European countries, the prevalence of CPE in Spain still remains relatively low although it is steadily increasing, with only a few outbreaks or sporadic isolates harboring VIM, KPC, OXA-48, or NDM-1 being reported (2). Since the identification of NDM-1 in a Swedish traveler returning from India (3), NDM enzymes have received special attention due to their rapid global spread and frequent association with additional resistance genes (4). There are currently 12 NDM variants (http://www.lahey.org), differing by one or two amino acid substitutions, that may display slightly different hydrolytic capabilities (4).The aim of this study was to characterize an NDM-5-producing Escherichia coli recovered in Spain from a nontraveler patient.A 78-year-old Spanish Caucasian female with a history of acute pyelonephritis treated with ceftriaxone (1 g/24 h) was positive for a carbapenem-resistant E. coli strain (HC105) in urine samples 15 days after the end of treatment. The patient was asymptomatic at this stage. The susceptibility testing using Etest strips (AB-bioMérieux, Solna, Sweden) and interpreted according to the EUCAST guidelines (version 4.0, 2014; http://www.eucast.org) indicated that HC105 was resistant to all of the antibiotics tested except tigecycline, fosfomycin, and colistin (MICs of 0.38 g/ml, 0.5 g/ml, and 0.125 g/ml, respectively) and had ertapenem, imipenem, and meropenem MICs of Ͼ32 g/ml (Table 1). The patient was successfully treated with fosfomycin (2 g/8 h), and no additional CPE were recovered. The screening of HC105 for carbapenemase/metallo-␤-lactamase (MBL) production using either the modified Hodge test or imipenem-EDTA Etest strips yielded positive results, suggesting carriage of an MBL. The PCR and sequence analysis for carbapenemase, extended-spectrum ␤-lactamase (ESBL), and plasmid-mediated AmpC cephalosporinaseencoding genes (5, 6) identified the presence of bla NDM-5 , bla TEM-1 , bla OXA-1 , and bla . The screening for 16S rRNA methylase genes (7) also identified the rmtB gene, conferring highlevel resistance to all aminoglycosides, in agreement with the susceptibility profile (Table 1). The multilocus sequence typing (http: //mlst.ucc.ie/mlst/dbs/Ecoli) and PCR-based phylogroup analysis (8) assigned E. coli HC105 to sequence type 4...

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Molecular Characterization of bla _NDM-5 Carried on an IncFII Plasmid in an Escherichia coli Isolate from a Nontraveler Patient in Spain

Pitart

Solé

Roca

et al. 2015

Antimicrob Agents Chemother

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“… 19 , 78 , 79 The European epidemiology for CRE changed between 2013 and 2015 for NDM-producing Enterobacteriaceae with several countries reporting regional or inter-regional spread but with no endemic situation. Single or sporadic hospital outbreaks caused by NDM-1 producing K. pneumoniae strains were reported from many countries in the Mediterranean area: France, 80 Italy, 81 Spain, 82 , 83 Morocco 84 Tunisia in a patient transferred from Libya, 85 and Egypt. 86 In these countries the dissemination of NDM-producing CRE, including K. pneumoniae , was still limited and cases were mostly acquired abroad.…”

Section: Epidemiology Of Crkp In Mediterranean Countriesmentioning

confidence: 99%

Epidemiology of Carbapenem Resistant Klebsiella Pneumoniae Infections in Mediterranean Countries

Girmenia

Serrao

Canichella

2016

Mediterr J Hematol Infect Dis

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Infections by Carbapenem-Resistant Enterobacteriaceae (CRE), in particular, carbapenem-resistant Klebsiella pneumoniae (CRKp), are a significant public health challenge worldwide. Resistance to carbapenems in enterobacteriaceae is linked to different mechanisms, including the production of the various types of enzymes like KPC, VIM, IMP, NDM, and OXA-48. Despite several attempts to control the spread of these infections at the local and national level, the epidemiological situation for CRKp had worsened in the last years in the Mediterranean area. The rate and types of CRKp isolates greatly differ in the various Mediterranean countries. KPC-producing K. pneumoniae is diffused particularly in the European countries bordering the Mediterranean Sea and is endemic in Greece and Italy. On the contrary, OXA-48-producing K. pneumoniae is endemic in Turkey and Malta and diffused at inter-regional level particularly in someNorth African and Middle East countries. The spread of these multiresistant pathogens in the world and the Mediterranean countries has been related to various epidemiological factors including the international transfer of patients coming from endemic areas.

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Multidrug-resistant Raoultella ornithinolytica misidentified as Klebsiella oxytoca carrying blaOXA β-lactamases: antimicrobial profile and genomic characterization

et al. 2021

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Nueva descripción en España de un portador de Klebsiella pneumoniae productora de una carbapenemasa NDM-1

Cited by 10 publications

References 8 publications

Molecular Characterization of bla _NDM-5 Carried on an IncFII Plasmid in an Escherichia coli Isolate from a Nontraveler Patient in Spain

Molecular Characterization of bla _NDM-5 Carried on an IncFII Plasmid in an Escherichia coli Isolate from a Nontraveler Patient in Spain

Epidemiology of Carbapenem Resistant Klebsiella Pneumoniae Infections in Mediterranean Countries

Multidrug-resistant Raoultella ornithinolytica misidentified as Klebsiella oxytoca carrying blaOXA β-lactamases: antimicrobial profile and genomic characterization

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Nueva descripción en España de un portador de Klebsiella pneumoniae productora de una carbapenemasa NDM-1

Cited by 10 publications

References 8 publications

Molecular Characterization of bla NDM-5 Carried on an IncFII Plasmid in an Escherichia coli Isolate from a Nontraveler Patient in Spain

Molecular Characterization of bla NDM-5 Carried on an IncFII Plasmid in an Escherichia coli Isolate from a Nontraveler Patient in Spain

Epidemiology of Carbapenem Resistant Klebsiella Pneumoniae Infections in Mediterranean Countries

Multidrug-resistant Raoultella ornithinolytica misidentified as Klebsiella oxytoca carrying blaOXA β-lactamases: antimicrobial profile and genomic characterization

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Molecular Characterization of bla _NDM-5 Carried on an IncFII Plasmid in an Escherichia coli Isolate from a Nontraveler Patient in Spain

Molecular Characterization of bla _NDM-5 Carried on an IncFII Plasmid in an Escherichia coli Isolate from a Nontraveler Patient in Spain