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Cuicapuza D, Loyola S, Velásquez J, Fernández N, Llanos C, Ruiz J, Tsukayama P, Tamariz J. Molecular characterization of carbapenemase-producing Enterobacterales in a tertiary hospital in Lima, Peru. Microbiol Spectr 2024; 12:e0250323. [PMID: 38193666 PMCID: PMC10846045 DOI: 10.1128/spectrum.02503-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/26/2023] [Indexed: 01/10/2024] Open
Abstract
Carbapenemase-producing Enterobacterales (CPE) are a growing threat to global health and the economy. Understanding the interactions between resistance and virulence mechanisms of CPE is crucial for managing difficult-to-treat infections and informing outbreak prevention and control programs. Here, we report the characterization of 21 consecutive, unique clinical isolates of CPE collected in 2018 at a tertiary hospital in Lima, Peru. Isolates were characterized by phenotypic antimicrobial susceptibility testing and whole-genome sequencing to identify resistance determinants and virulence factors. Seven Klebsiella pneumoniae isolates were classified as extensively drug-resistant. The remaining Klebsiella, Enterobacter hormaechei, and Escherichia coli isolates were multidrug-resistant. Eighteen strains carried the metallo-β-lactamase NDM-1, two the serine-carbapenemase KPC-2, and one isolate had both carbapenemases. The blaNDM-1 gene was located in the truncated ΔISAba125 element, and the blaKPC-2 gene was in the Tn4401a transposon. ST147 was the most frequent sequence type among K. pneumoniae isolates. Our findings highlight the urgent need to address the emergence of CPE and strengthen control measures and antibiotic stewardship programs in low- and middle-income settings.IMPORTANCEGenomic surveillance of antimicrobial resistance contributes to monitoring the spread of resistance and informs treatment and prevention strategies. We characterized 21 carbapenemase-producing Enterobacterales collected at a Peruvian tertiary hospital in 2018, which exhibited very high levels of resistance and carried numerous resistance genes. We detected the coexistence of carbapenemase-encoding genes (blaNDM-1 and blaKPC-2) in a Klebsiella pneumoniae isolate that also had the PmrB(R256G) mutation associated with colistin resistance. The blaKPC-2 genes were located in Tn4401a transposons, while the blaNDM-1 genes were in the genetic structure Tn125 (ΔISAba125). The presence of high-risk clones among Klebsiella pneumoniae (ST11 and ST147) and Escherichia coli (ST410) isolates is also reported. The study reveals the emergence of highly resistant bacteria in a Peruvian hospital, which could compromise the effectiveness of current treatments and control.
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Affiliation(s)
- Diego Cuicapuza
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
- Laboratorio de Resistencia Antibiótica e Inmunopatología, Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
- Laboratorio de Genómica Microbiana, Facultad de Ciencias e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru
- Emerge (Emerging Diseases and Climate Change Research Unit), Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Steev Loyola
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
- Laboratorio de Resistencia Antibiótica e Inmunopatología, Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
- Grupo de Investigación UNIMOL, Facultad de Medicina, Universidad de Cartagena, Cartagena de Indias, Colombia
| | - Jorge Velásquez
- Departamento de Patología Clínica y Banco de Sangre, Hospital Nacional Arzobispo Loayza, Lima, Peru
| | - Nathaly Fernández
- Departamento de Patología Clínica y Banco de Sangre, Hospital Nacional Arzobispo Loayza, Lima, Peru
| | - Carlos Llanos
- Laboratorio de Resistencia Antibiótica e Inmunopatología, Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Joaquim Ruiz
- Grupo de Investigación en Dinámicas y Epidemiología de la Resistencia a Antimicrobianos-“One Health”, Universidad Científica de Sur, Lima, Peru
| | - Pablo Tsukayama
- Laboratorio de Genómica Microbiana, Facultad de Ciencias e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Peru
- Emerge (Emerging Diseases and Climate Change Research Unit), Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- Parasites and Microbes Programme, Wellcome Sanger Institute, Hinxton, United Kingdom
| | - Jesús Tamariz
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
- Laboratorio de Resistencia Antibiótica e Inmunopatología, Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
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IWATA SHU, TADA TATSUYA, OSHIRO SATOSHI, HISHINUMA TOMOMI, TOHYA MARI, KIRIKAE TERUO. Emergence of Carbapenem-resistant Clinical Isolates of Providencia Species. JUNTENDO IJI ZASSHI = JUNTENDO MEDICAL JOURNAL 2022; 68:200-207. [PMID: 39021729 PMCID: PMC11250026 DOI: 10.14789/jmj.jmj21-0057-r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 01/28/2022] [Indexed: 07/20/2024]
Abstract
Providencia is a genus of Gram-negative and non-spore forming bacteria belonging to the family Morganellaceae, which causes opportunistic infections in humans. Of the 10 Providencia species identified to date, three, P. alcalifaciens, P. rettgeri and P. stuartii, are clinically important. P. alcalifaciens causes diarrhea, including outbreaks arising from food-borne infections, and P. stuartii and P. rettgeri have been found to cause hospital acquired urinary tract infections. Four isolates of P. rettgeri and one isolate of P. stuartii were obtained from urine samples of five patients in Japan in 2018. All five isolates were highly resistant to carbapenems. Three isolates harbored bla IMP-70, encoding a variant of IMP-1 metallo-β-lactamase, with two amino acid substitutions (Val67Phe and Phe87Val), one isolate harbored two copies of bla IMP-1 and one isolate harbored bla IMP-11. Expression of bla IMP-70 conferred carbapenem resistance in Escherichia coli. Recombinant IMP-10, an IMP-1 variant with Val67Phe but without Phe87Val, had significant higher hydrolytic activities against meropenem than recombinant IMP-1, indicating that the Val67Phe amino acid substitution alters activities against meropenem in IMP-70. These results suggest that Providencia species. become more highly resistant to carbapenems by acquisition of two copies of bla IMP-1 or by mutations in bla IMP that result in amino acid substitutions, such as bla IMP-70.
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Affiliation(s)
| | | | | | | | | | - TERUO KIRIKAE
- Corresponding author: Teruo Kirikae, Department of Microbiology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan, TEL: +81-3-5802-1041 FAX: +81-3-5684-7830 E-mail: , Research of the 5th Alumni Scientific Award for Medical Student, Juntendo University School of Medicine
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Chen W, Liu Z, Lin H, Yang J, Liu T, Zheng J, Long X, Sun Z, Li J, Chen X. Occurrence of blaNDM-1-Positive Providencia spp. in a Pig Farm of China. Antibiotics (Basel) 2022; 11:antibiotics11060713. [PMID: 35740120 PMCID: PMC9219741 DOI: 10.3390/antibiotics11060713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/23/2022] [Accepted: 05/23/2022] [Indexed: 12/04/2022] Open
Abstract
Antibiotics have been extensively used to ensure the productivity of animals on intensive livestock farms. Accordingly, antimicrobial-resistant organisms, which can be transmitted to humans via the food chain, pose a threat to public health. The Enterobacterium antimicrobial resistance gene, blaNDM-1, is a transmissible gene that has attracted widespread attention. Here, we aimed to investigate the prevalence of Enterobacteriaceae carrying blaNDM-1 on an intensive pig farm. A total of 190 samples were collected from a pig farm in Hunan Province, China. Resistant isolates were selected using MacConkey agar with meropenem and PCR to screen for blaNDM-1-positive isolates. Positive strains were tested for conjugation, antimicrobial susceptibility, and whole-genome sequencing. Four blaNDM-1-positive Providencia strains were obtained, and multidrug resistance was observed in these strains. The structure carrying blaNDM-1 did not conjugate to E. coli J53 after three repeated conjugation assays. This suggests that, in intensive farming, attention should be focused on animal health and welfare to reduce the frequency of antibiotic usage. Carbapenem-resistant Enterobacteriaceae in the breeding industry should be included in systematic monitoring programs, including animal, human, and environmental monitoring programs.
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Affiliation(s)
- Wenxin Chen
- College of Veterinary Medicine, Hunan Agricultural University, Changsha 410128, China; (W.C.); (Z.L.); (H.L.); (J.Y.); (T.L.); (Z.S.)
- Hunan Engineering Technology Research Center of Veterinary Drugs, Hunan Agricultural University, Changsha 410128, China
| | - Zhihong Liu
- College of Veterinary Medicine, Hunan Agricultural University, Changsha 410128, China; (W.C.); (Z.L.); (H.L.); (J.Y.); (T.L.); (Z.S.)
- Hunan Engineering Technology Research Center of Veterinary Drugs, Hunan Agricultural University, Changsha 410128, China
| | - Hongguang Lin
- College of Veterinary Medicine, Hunan Agricultural University, Changsha 410128, China; (W.C.); (Z.L.); (H.L.); (J.Y.); (T.L.); (Z.S.)
- Hunan Engineering Technology Research Center of Veterinary Drugs, Hunan Agricultural University, Changsha 410128, China
| | - Jie Yang
- College of Veterinary Medicine, Hunan Agricultural University, Changsha 410128, China; (W.C.); (Z.L.); (H.L.); (J.Y.); (T.L.); (Z.S.)
- Hunan Engineering Technology Research Center of Veterinary Drugs, Hunan Agricultural University, Changsha 410128, China
| | - Ting Liu
- College of Veterinary Medicine, Hunan Agricultural University, Changsha 410128, China; (W.C.); (Z.L.); (H.L.); (J.Y.); (T.L.); (Z.S.)
- Hunan Engineering Technology Research Center of Veterinary Drugs, Hunan Agricultural University, Changsha 410128, China
| | - Jiaomei Zheng
- Changsha Animal and Plant Disease Control Center, Changsha 410003, China;
| | - Xueming Long
- Hunan Provincial Institution of Veterinary Drug and Feed Control, Changsha 410006, China;
| | - Zhiliang Sun
- College of Veterinary Medicine, Hunan Agricultural University, Changsha 410128, China; (W.C.); (Z.L.); (H.L.); (J.Y.); (T.L.); (Z.S.)
- Hunan Engineering Technology Research Center of Veterinary Drugs, Hunan Agricultural University, Changsha 410128, China
| | - Jiyun Li
- College of Veterinary Medicine, Hunan Agricultural University, Changsha 410128, China; (W.C.); (Z.L.); (H.L.); (J.Y.); (T.L.); (Z.S.)
- Hunan Engineering Technology Research Center of Veterinary Drugs, Hunan Agricultural University, Changsha 410128, China
- Correspondence: (J.L.); (X.C.)
| | - Xiaojun Chen
- College of Veterinary Medicine, Hunan Agricultural University, Changsha 410128, China; (W.C.); (Z.L.); (H.L.); (J.Y.); (T.L.); (Z.S.)
- Hunan Engineering Technology Research Center of Veterinary Drugs, Hunan Agricultural University, Changsha 410128, China
- Correspondence: (J.L.); (X.C.)
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