Prevalence of, and risk factors for, carriage of carbapenem-resistant Enterobacteriaceae among hospitalized patients in Japan

Yamamoto, Naoki; Asada, Rumiko; Kawahara, Ryuji; Hagiya, Hideharu; Akeda, Yukihiro; Shanmugakani, Rathina Kumar; Yoshida, Hisao; Yukawa, Satoshi; Yamamoto, Kei; Takayama, Yoko; Ohnishi, Hiroyuki; Taniguchi, Takao; Matsuoka, Toru; Matsunami, Katsura; Nishi, Isao; Kase, Tetsuo; Hamada, Shigeyuki; Tomono, Kazunori

doi:10.1016/j.jhin.2017.07.015

Cited by 78 publications

(83 citation statements)

References 26 publications

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“…The single amino-acid variant, IMP-6, was identi ed in 2001 [17]. IMP-1 producers have disseminated mainly in eastern Japan, including Tokyo [23,24,33], whereas IMP-6 producers have been almost exclusively found in western Japan, including Osaka [7,10,11,24]. Consistent herewith, in this study, only one K. pneumoniae isolate carrying bla IMP−1 , E105, was isolated in hospital A, where CRE carrying pKPI-6 were dominant.…”

Section: Discussionsupporting

confidence: 86%

“…CRE Isolates and PFGE Phylogenetic Analysis. We performed a CRE surveillance study of 1,507 patients hospitalized in 43 hospitals located in northern Osaka between December 2015 and January 2016 [10]. In the current study, we analysed 230 CRE isolates carrying bla IMP obtained in the surveillance study, including 135 E. coli isolates and 95 K. pneumoniae isolates.…”

Section: Methodsmentioning

confidence: 99%

“…We previously conducted a surveillance study of CRE in 1,507 patients from 43 hospitals in northern Osaka (population: 1,170,000, area: 307 km 2 ), Japan [10], and we reported that 12% of the patients carried CRE and 95% of CRE isolates harboured bla IMP−6 , the predominant carbapenemase in Japan. The predominance of this particular carbapenemase gene might have resulted from vigorous horizontal spreading of a speci c plasmid carrying bla IMP−6 , pKPI-6 [11], in this region.…”

Section: Introductionmentioning

confidence: 99%

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Regional Dissemination of a Carbapenemase-encoding Plasmid: Plasmidome analysis Reveals Diverse Adaptations of Carbapenemase-Producing Enterobacteriaceae

Abe¹,

Akeda²,

Sugawara³

et al. 2020

Preprint

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Background. The global dissemination of carbapenem-resistant Enterobacteriaceae (CRE) threatens human health by limiting the range of usable antibiotics even against common bacterial infections. The spread of CRE is primarily due to the transmission of carbapenemase genes located on plasmids. However, few studies have comprehensively identified regionally spreading carbapenemase-encoding plasmids because of the difficulty to determine the complete sequence of a plasmid encoding carbapenemases. In a CRE surveillance study of 1,507 patients from 43 hospitals in northern Osaka, Japan, we previously found that 12% of the patients carried CRE and 95% of CRE isolates were IMP-6 producers. This result suggested a vast horizontal spread of a clonal plasmid carrying blaIMP-6 among Enterobacteriaceae in this region. In the current study, we aimed to describe the dynamics of this regional horizontal plasmid transmission.Results. We systematically analysed the plasmids of 230 CRE isolates carrying blaIMP obtained in our previous surveillance study by using whole genome sequencing and Southern blotting. We detected a major population (187 out of 230 blaIMP-positive CRE isolates, 85.6%) that carried blaIMP-6 on the IncN plasmid pKPI-6, along with diverse minor subpopulations. Among the subpopulations, we identified a novel cluster carrying an IncF plasmid that leads to heteroresistance due to amplification of blaIMP-6, resulting in covert transmission of blaIMP-6 or occasional chromosomal integration of blaIMP-6. In addition, we detected one isolate that harboured blaIMP-1, which is identical to blaIMP-6 except for a single point mutation, on pKPI-6 and thus had acquired a broader range of antimicrobial resistance. Conclusions. Carbapenemase-encoding plasmid tracking revealed the clonal dissemination of pKPI-6 among chromosomally distinct isolates. Focusing on the mode of carbapenemase gene carriage is helpful for monitoring of horizontal spread of CRE isolates that is difficult to trace only by the comparisons of the whole genomes. A seemingly clonal horizontal dissemination of the predominant plasmid had embraced heterogenous subpopulations that contribute to diverse adaptations including covert transmission, stable chromosomal integration of blaIMP-6, or broadened antimicrobial resistance patterns, ultimately leading to treatment failure.

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Section: Discussionsupporting

confidence: 86%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Regional Dissemination of a Carbapenemase-encoding Plasmid: Plasmidome analysis Reveals Diverse Adaptations of Carbapenemase-Producing Enterobacteriaceae

Abe¹,

Akeda²,

Sugawara³

et al. 2020

Preprint

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“…A prevalência na população de risco, após triagem de risco, internada por qualquer causa, foi estimada em 12%, conforme dados de literatura (Yamamoto et al, 2017).…”

Section: Prevalênciasunclassified

Custo-efetividade de teste rápido de detecção de Klebsiella spp. para rastreio hospitalar

Rocha¹,

Rocha²,

Alcantara³

et al. 2019

JBES

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“…Owing to the fact that the prevalence of stealth bacteria (carrying AMR genes but not identifiable by existing susceptibility tests) has been increasing (16), the establishment of a simple and easyto-use detection method for such strains at the genetic level is an important task in the clinical setting. Our results demonstrated that the PhagoCas13a(s) could be applied for the detection and identification of AMR genes.…”

mentioning

confidence: 99%

Development of CRSIPR-Cas13a-based antimicrobials capable of sequence-specific killing of target bacteria

Kiga

Tan

Ibarra-Chávez

et al. 2019

Preprint

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Emergence of antimicrobial-resistant bacteria is an increasingly serious threat to global health, necessitating the development of innovative antimicrobials. We established a series of CRISPR-Cas13a-based antimicrobials, termed PhagoCas13a(s), capable of sequence-specific killing of carbapenem-resistant Escherichia coli and methicillin-resistant Staphylococcus aureus through promiscuous RNA cleavage after recognizing corresponding antimicrobial resistance genes. PhagoCas13a constructs were generated by packaging CRISPR-Cas13a into a bacteriophage to target antimicrobial resistance genes. Contrary to Cas9-based antimicrobials that lack bacterial killing capacity when the target genes are located on a plasmid, the PhagoCas13a(s) exhibited strong bacterial killing activities upon recognizing target genes regardless of their location. The antimicrobials' treatment efficacy was confirmed using a Galleria mellonella larvae model. Further, we demonstrated that the PhagoCas13a(s) can assist in bacterial gene detection without employing nucleic acid amplification and optical devices.

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Prevalence of, and risk factors for, carriage of carbapenem-resistant Enterobacteriaceae among hospitalized patients in Japan

Cited by 78 publications

References 26 publications

Regional Dissemination of a Carbapenemase-encoding Plasmid: Plasmidome analysis Reveals Diverse Adaptations of Carbapenemase-Producing Enterobacteriaceae

Regional Dissemination of a Carbapenemase-encoding Plasmid: Plasmidome analysis Reveals Diverse Adaptations of Carbapenemase-Producing Enterobacteriaceae

Custo-efetividade de teste rápido de detecção de Klebsiella spp. para rastreio hospitalar

Development of CRSIPR-Cas13a-based antimicrobials capable of sequence-specific killing of target bacteria

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