A hospital-wide outbreak of IMI-17-producing Enterobacter ludwigii in an Israeli hospital

The occurrence and genomic characteristics of the blaIMI-1 carbapenemase-producing Enterobacter cloacae complex retrieved from natural water sources in central Thailand

AIM

Carbapenem resistance among Enterobacteriaceae is a serious threat to humans worldwide. This study aims to evaluate the phenotypic and genotypic characterization of carbapenemase-producing Enterobacter cloacae complex (ECC) retrieved from water sources in the central part of Thailand.

METHODS AND RESULTS

Samples were collected from water bodies surrounding farms and communities in central Thailand. The species were identified by using MALDI-TOF MS. The minimum inhibitory concentration (MIC) and antibiotic susceptibility were determined. The carbapenemase-producing genes were detected by PCR and whole genome sequencing (WGS). ECC with chromosome-encoded blaIMI-1 carbapenemase were detected. These isolates were resistant to last-resort antibiotics such as carbapenems and colistin as well as penicillin. In addition, all blaIMI-1 genes isolated from this study were found to be associated with chromosomally integrated Xer-dependent integrative mobile elements (IMEXs).

CONCLUSION

These findings highlight the diversity and dissemination of carbapenemases-producing Enterobacterales in environmental sources. With the increasing detection of carbapenemase genes worldwide, we should be aware of the blaIMI-producing E. cloacae complex with a high resistance profile and the ability to mobilize within the environment.

Phenotypic and Molecular Characterization of an Enterobacter ludwigii Clinical Isolate Carrying a Plasmid-Mediated blaIMI-6 Gene

We report a plasmid-encoded IMI-6 carbapenemase in a clinical isolate of Enterobacter ludwigii from Spain. The isolate belongs to ST641 and was susceptible to expanded-spectrum cephalosporins and resistant to carbapenems. The modified carbapenem inactivation method (mCIM) test was positive, but β-Carba was negative. Whole-genome sequencing identified the blaIMI-6 gene located in a conjugative IncFIIY plasmid and associated with the LysR-like regulator imiR. Both genes were bracketed by an ISEclI-like insertion sequence and a putatively defective ISEc36 insertion sequence. IMPORTANCE IMI carbapenemases confer an unusual resistance pattern of susceptibility to broad-spectrum cephalosporins and piperacillin-tazobactam but decreased susceptibility to carbapenems, which may make them difficult to detect in routine practice. Commercially available molecular methods for the detection of carbapenemases in clinical laboratories do not usually include blaIMI genes, which could contribute to the hidden dissemination of bacteria producing these enzymes. Techniques should be implemented to detect minor carbapenemases that are not very frequent in our environment and control their dissemination.

The Dissemination of a Single Staphylococcusaureus Strain, Spa-t2873, as the Predominant Cause of Bovine Mastitis in Israeli Dairy Farms

Simple Summary

Staphylococcus aureus is one of the most important pathogens causing intramammary infection (IMI) in cattle. We aimed to characterize which are the specific strains that are responsible for the majority of these cases. During the one-year survey, S. aureus was identified in 152 dairy farms, with a total of 440 positive samples. One specific type (designated-spa t2873) was found in 284 isolates (64.5%). Notably, 25 cases were detected in one specific farm, all of which were found to be dominant spa t2873 type. By using genomic analysis, we were able to ascertain that most transmission events occurred within the same milking group. Our study revealed the dissemination of a single strain to the majority of Israeli dairy farms. The possibility of inter-farm transmission should be monitored and prevented.

Abstract

Staphylococcus aureus is one of the most important pathogens causing intramammary infection (IMI) in dairy herds. The goals of this study were (1) to describe the prevalence of S. aureus in Israeli dairy farms; (2) to characterize the spa-based clonal structure of mastitis-related S. aureus isolates; (3) to analyze the transmission network of a large outbreak within a single farm and (4) to characterize the virulence factors of the outbreak strain. The prevalence and the molecular survey were performed on all Israeli IMI-related isolates, 9.2019–8.2020. Molecular methods included spa-typing for the survey and whole-genome sequencing (WGS) for the investigation of the farm ‘A’ outbreak. During the one-year survey, S. aureus was identified in 152 dairy farms, with a total of 440 positive samples. The spa t2873 was found in 284 isolates (64.5%) across 112 farms (73.6%). Other common types included t529 (n = 46), t9303 (n = 34) and the methicillin-resistant S. aureus t011 (n = 11). The highest number of cases (n = 25) was detected in Farm ‘A’, all of which were found to be spa t2873. Phylogenetic analysis confirmed that most transmission events occurred within the same milking group, and inter-group transmission was due to the transfer of cows between groups or due to consecutive milking order. The spa t2873 strain contained putative virulence genes, including various intracellular and collagen adhesion proteins. Our study revealed the dissemination of the t2873 strain to the majority of Israeli dairy farms. The possibility of inter-farm transmission should be monitored and prevented.