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Cornejo-Sánchez T, Soldevila N, Coronas L, Alsedà M, Godoy P, Razquín E, Sabaté S, Guix S, Rodríguez Garrido V, Bartolomé R, Domínguez A, Belver AI, Camps N, Minguell S, Carol M, Izquierdo C, Parrón I, Pérez C, Rovira A, Sabaté M, Sala MR, Vileu RM, Barrabeig I, Jané M, Martínez A, Torner N, de Benito J, Moreno-Martínez A, Rius C, de Andres A, Camprubí E, Cunillé M, Forns ML, de Simón M. Epidemiology of GII.4 and GII.2 norovirus outbreaks in closed and semi-closed institutions in 2017 and 2018. Sci Rep 2023; 13:1659. [PMID: 36717621 PMCID: PMC9886968 DOI: 10.1038/s41598-023-28448-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 01/18/2023] [Indexed: 01/31/2023] Open
Abstract
Norovirus infections are a leading cause of acute gastroenteritis outbreaks worldwide, with genotypes GII.2 and GII.4 being the most prevalent. The aim of this study was to compare the characteristics of GII.2 and GII.4 norovirus outbreaks reported in Catalonia in closed or semi-closed institutions in 2017 and 2018. The epidemiological and clinical characteristics of GII.2 and GII.4 outbreaks were compared using the chi-square test or Fisher's exact test for categorical variables and the Mann-Whitney U test for continuous variables. Odds ratios and their 95% confidence intervals were estimated. 61 outbreaks were reported: GII.4 was the causative agent in 12 outbreaks (30%) and GII.2 in 9 outbreaks (22.5%). GII.2 outbreaks were detected more frequently in schools or summer camps (66.7%) and GII.4 outbreaks in nursing homes (91.7%) (p = 0.01). Ninety-three people were affected in GII.2 outbreaks and 94 in GII.4 outbreaks. The median age was 15 years (range: 1-95 years) in GII.2 outbreaks and 86 years (range: 0-100 years) in GII.4 outbreaks (p < 0.001). Nausea, abdominal pain, and headache were observed more frequently in persons affected by GII.2 outbreaks (p < 0.05). Symptomatic cases presented a higher viral load suggestive of greater transmission capacity, although asymptomatic patients presented relevant loads indicative of transmission capacity.
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Affiliation(s)
| | - Núria Soldevila
- CIBER Epidemiología y Salut Pública (CIBERSP), Madrid, Spain. .,Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.
| | - Lorena Coronas
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.,Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Miquel Alsedà
- Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Pere Godoy
- CIBER Epidemiología y Salut Pública (CIBERSP), Madrid, Spain.,Agència de Salut Pública de Catalunya, Barcelona, Spain.,Institut de Recerca Biomédica de Lleida, IRB Lleida, Lleida, Spain
| | - Efrén Razquín
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - Sara Sabaté
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
| | - Susana Guix
- Departament de Genètica Microbiologia i Estadística, Grup de Virus Entèrics, Universitat de Barcelona, Barcelona, Spain.,Nutrition and Food Safety Research Institute (INSA·UB), Universitat de Barcelona, 08921, Santa Coloma de Gramenet, Spain
| | | | - Rosa Bartolomé
- Laboratori de Microbiologia, Hospital Universitari Vall d'Hebrón, Barcelona, Spain
| | - Angela Domínguez
- CIBER Epidemiología y Salut Pública (CIBERSP), Madrid, Spain.,Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
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Parrón I, Barrabeig I, Alseda M, Rius C, Cornejo-Sánchez T, Jané M, Pérez C, Guix S, Domínguez À. Norovirus outbreaks in long-term care facilities in Catalonia from 2017 to 2018. Sci Rep 2021; 11:23218. [PMID: 34853333 PMCID: PMC8636624 DOI: 10.1038/s41598-021-02348-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 11/10/2021] [Indexed: 11/09/2022] Open
Abstract
Norovirus is the leading cause of outbreaks of acute viral gastroenteritis. We carried out this study to investigate outbreaks in long-term care facilities reported in 2017 and 2018 in Catalonia (Spain). The characteristics of the centers, exposed persons and the genogroups responsible were analyzed. Viral loads were estimated. The attack rate (AR) of the outbreaks studied, and the rate ratio (RR) and the odds ratio (OR) and their 95% confidence intervals as measures of association were calculated. The mean cycle thresholds were compared using the t-test for independent means. We included 30 outbreaks (4631 exposed people). The global AR was 25.93%. The RR of residents vs. staff was 2.28 (95% CI 2.0–2.6). The RR between AR in residents with total or severe dependence vs. residents with moderate, low or no-dependence was 1.23 (95% CI 1.05–1.45). The AR were higher in smaller centers than in larger ones (38.47% vs. 19.25% and RR 2; 95% CI 1.82–2.2). GII was responsible for 70% of outbreaks. No association was found between the genogroup and presenting symptoms (OR 0.96; 95% CI 0.41–2.26). Viral loads were higher in symptomatic than in asymptomatic patients (p = 0.001).
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Affiliation(s)
- Ignacio Parrón
- Sub-Direcció Regional a Barcelona del Departament de Salut, Barcelona, Spain. .,Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.
| | - Irene Barrabeig
- Sub-Direcció Regional a Barcelona del Departament de Salut, Barcelona, Spain.,CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Miquel Alseda
- Sub-Direcció Regional a Lleida del Departament de Salut, Lleida, Spain
| | - Cristina Rius
- CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain.,Agència de Salut Pública de Barcelona, Barcelona, Spain
| | | | - Mireia Jané
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.,CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain.,Sub-Direcció General de Vigilància i Resposta a Emergències de Salut Pública, Barcelona, Spain
| | - Cristina Pérez
- Sub-Direcció Regional a Barcelona del Departament de Salut, Barcelona, Spain
| | - Susana Guix
- Departament de Genètica Microbiologia i Estadística, Grup de Virus Entèrics, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca en Nutrició i Seguretat Alimentària (INSA-UB), Universitat de Barcelona, Santa Coloma de Gramenet, Spain
| | - Àngela Domínguez
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.,CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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Moreno-Mingorance A, Espinal P, Rodriguez V, Goterris L, Fàbrega A, Serra-Pladevall J, Barberà MJ, Alberny M, Martín-González H, Cornejo-Sánchez T, Armas M, Mir-Cros A, Raventós A, Viñado B, Pumarola T, Larrosa MN, González-López JJ. Circulation of multi-drug-resistant Shigella sonnei and Shigella flexneri among men who have sex with men in Barcelona, Spain, 2015-2019. Int J Antimicrob Agents 2021; 58:106378. [PMID: 34157402 DOI: 10.1016/j.ijantimicag.2021.106378] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/20/2021] [Accepted: 06/13/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND In high-income countries, shigellosis is mainly found in travellers to high-risk regions or in men who have sex with men (MSM). This study investigated the genomic characteristics and the features of antimicrobial resistance of MSM-associated Shigella flexneri and Shigella sonnei circulating in Barcelona, Spain, elucidating their connectivity with contemporaneous Shigella spp. from other countries. METHODS Antimicrobial susceptibility, whole-genome sequencing, genomic characterization and phylogenetic analysis were performed in MSM-associated Shigella spp. recovered from 2015 to 2019. Reference genomes of MSM-associated Shigella spp. were included for contextualization and to determine their connection with international outbreaks. RESULTS In total, 44 S. flexneri and 26 S. sonnei were identified among MSM. Overall, 80% showed resistance to azithromycin, 65.7% showed resistance to trimethoprim-sulphamethoxazole and 32.8% showed resistance to ciprofloxacin; 27.1% were resistant to all three antimicrobials. mphA and/or ermB, and qnrS and mutations in the quinolone resistance determining regions were found in the azithromycin- and ciprofloxacin-resistant isolates, respectively. Additionally, two isolates carried blaCTX-M-27. Single-nucleotide-polymorphism-based analysis revealed that the isolates were organized into different lineages, most of which were closely related to dominant MSM-associated lineages described previously in the UK and Australia. CONCLUSIONS This study investigated the circulation of lineages of S. flexneri and S. sonnei among MSM in Spain that were mainly resistant to first-/second-line oral treatments, and closely related to dominant MSM-associated lineages described previously in the UK and Australia. These data reinforce the urgent need for the implementation of public health measures focusing on the early detection and prevention of transmission of this emerging pathogen, which is contributing to the antimicrobial resistance crisis in sexually transmitted infections.
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Affiliation(s)
- Albert Moreno-Mingorance
- Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Paula Espinal
- Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Virginia Rodriguez
- Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Department of Clinical Microbiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Lidia Goterris
- Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Department of Clinical Microbiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Anna Fàbrega
- Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Department of Clinical Microbiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Judit Serra-Pladevall
- Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Department of Clinical Microbiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - M Jesús Barberà
- Drassanes-Vall d'Hebron Sexually Transmitted Infections Unit, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Mireia Alberny
- Primary Healthcare Division, Catalan Institute of Health, Barcelona, Spain
| | - Héctor Martín-González
- Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Thais Cornejo-Sánchez
- Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Mayuli Armas
- Department of Clinical Microbiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Alba Mir-Cros
- Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alex Raventós
- Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Belén Viñado
- Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Clinical Microbiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Tomàs Pumarola
- Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Clinical Microbiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - M Nieves Larrosa
- Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Clinical Microbiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain.
| | - Juan José González-López
- Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Clinical Microbiology, Vall d'Hebron Hospital Universitari, Barcelona, Spain.
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Parrón I, Barrabeig I, Alseda M, Cornejo-Sánchez T, Guix S, Jané M, Izquierdo C, Rius C, Domínguez À. Involvement of Workers in Closed and Semiclosed Institutions in Outbreaks of Acute Gastroenteritis Due to Norovirus. Viruses 2020; 12:E1392. [PMID: 33291823 PMCID: PMC7762007 DOI: 10.3390/v12121392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 12/19/2022] Open
Abstract
Norovirus outbreaks frequently occur in closed or semiclosed institutions. Recent studies in Catalonia and various countries indicate that, during outbreaks in these institutions, norovirus is detected in between 23% and 60% of workers, and the prevalence of infection in asymptomatic workers involved in outbreaks ranges from 17% to 40%. In this work, we carried out a prospective study to investigate the involvement of workers in closed and semiclosed institutions during outbreaks. The attack rates (ARs) and the rate ratios (RRs) were calculated according to the type of transmission and occupational category. The RRs and 95% confidence intervals (CIs) between workers and users were calculated. The mean cycle of quantification (Cq) values were compared according to the genogroup and the presence of symptoms. ARs were higher in person-to-person transmission than in common vehicle outbreaks, and 38.8% of workers were symptomatic. The RR between workers and users was 0.46 (95% CI 0.41-0.52). The ARs in workers were high, particularly in workers with closer contact with users. The mean Cq was lower in patients than in asymptomatic infected persons, although the difference was only significant for genogroup I (GI). The frequency of asymptomatic infected persons suggests that personal hygiene measures should be followed by all workers in the centers affected.
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Affiliation(s)
- Ignacio Parrón
- Sub-Direcció Regional a Barcelona del Departament de Salut, 08005 Barcelona, Spain;
| | - Irene Barrabeig
- Sub-Direcció Regional a Barcelona del Departament de Salut, 08005 Barcelona, Spain;
- CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.J.); (C.R.); (À.D.)
| | - Miquel Alseda
- Sub-Direcció Regional a Lleida del Departament de Salut, 25006 Lleida, Spain;
| | | | - Susana Guix
- Enteric Virus Laboratory, Department of Genetics, Microbiology and Statistics, Section of Microbiology, Virology and Biotechnology, School of Biology, Institute of Nutrition and Food Safety, University of Barcelona, 08028 Barcelona, Spain;
| | - Mireia Jané
- CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.J.); (C.R.); (À.D.)
- Sub-Direcció General de Vigilància i Resposta a Emergències de Salut Pública, 08005 Barcelona, Spain;
- Departament de Medicina, Universitat de Barcelona, 08036 Barcelona, Spain
| | - Conchita Izquierdo
- Sub-Direcció General de Vigilància i Resposta a Emergències de Salut Pública, 08005 Barcelona, Spain;
| | - Cristina Rius
- CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.J.); (C.R.); (À.D.)
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
| | - Àngela Domínguez
- CIBER Epidemiologia y Salud Pública, Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.J.); (C.R.); (À.D.)
- Departament de Medicina, Universitat de Barcelona, 08036 Barcelona, Spain
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5
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Mir-Cros A, Moreno-Mingorance A, Martín-Gómez MT, Codina G, Cornejo-Sánchez T, Rajadell M, Van Esso D, Rodrigo C, Campins M, Jané M, Pumarola T, Fàbrega A, González-López JJ. Population dynamics and antigenic drift of Bordetella pertussis following whole cell vaccine replacement, Barcelona, Spain, 1986-2015. Emerg Microbes Infect 2019; 8:1711-1720. [PMID: 31769735 PMCID: PMC6882445 DOI: 10.1080/22221751.2019.1694395] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Among the factors associated with the resurgence of whooping cough, special emphasis has been given to pathogen adaptation after the introduction of the acellular vaccine (ACV). To assess the impact of the vaccine transition strategy from whole-cell vaccine (WCV) to ACV on population dynamics of Bordetella pertussis in Barcelona (Spain), we studied 339 isolates collected from 1986 to 2015 by PFGE and multi-locus variable-number tandem repeat analysis (MLVA). Additionally, allelic variants for the pertussis toxin and its promoter, pertactin, type 3 fimbriae and fimbrial serotyping were assessed to determine its antigenic drift. A shift was observed in the B. pertussis population as well as in its antigenic profile concurrently with the introduction of ACV in Barcelona. Four out of the five most prevalent PFGE profiles were replaced by new profiles following the ACV introduction. MLVA type 27 was the dominant genotype, and its frequency increased from 25% to 79.3% after WCV replacement. Antigen typing demonstrated the emergence of prn2, ptxP3, fim3-2 and a shift from the fimbriae 3 to the fimbriae 2 serotypes after the ACV introduction. Our findings support the presence of population and antigenic dynamic changes in B. pertussis likely driven by the introduction of ACV.
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Affiliation(s)
- Alba Mir-Cros
- Department of Clinical Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Microbiology and Genetics, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Albert Moreno-Mingorance
- Department of Clinical Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Microbiology and Genetics, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Teresa Martín-Gómez
- Department of Clinical Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Gema Codina
- Department of Clinical Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Thais Cornejo-Sánchez
- Department of Clinical Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Mireia Rajadell
- Department of Clinical Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Microbiology and Genetics, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Diego Van Esso
- Primary Care Health Centre Service 'Muntanya', Catalan Institute of Health, Barcelona, Spain
| | - Carlos Rodrigo
- Department of Paediatrics, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Magda Campins
- Department of Preventive Medicine and Epidemiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Mireia Jané
- Public Health Agency of Catalonia, Barcelona, Spain
| | - Tomàs Pumarola
- Department of Clinical Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Microbiology and Genetics, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Fàbrega
- Department of Clinical Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Faculty of Health Sciences, University of Vic - Central University of Catalonia (UVic-UCC), Manresa, Spain
| | - Juan José González-López
- Department of Clinical Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Microbiology and Genetics, Universitat Autònoma de Barcelona, Barcelona, Spain
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Brown-Jaque M, Rodriguez Oyarzun L, Cornejo-Sánchez T, Martín-Gómez MT, Gartner S, de Gracia J, Rovira S, Alvarez A, Jofre J, González-López JJ, Muniesa M. Detection of Bacteriophage Particles Containing Antibiotic Resistance Genes in the Sputum of Cystic Fibrosis Patients. Front Microbiol 2018; 9:856. [PMID: 29765367 PMCID: PMC5938348 DOI: 10.3389/fmicb.2018.00856] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 04/13/2018] [Indexed: 11/13/2022] Open
Abstract
Cystic fibrosis (CF) is a chronic disease in which the bacterial colonization of the lung is linked to an excessive inflammatory response that leads to respiratory failure. The microbiology of CF is complex. Staphylococcus aureus is the first bacterium to colonize the lungs in 30% of pediatric CF patients, and 80% of adult patients develop a chronic Pseudomonas aeruginosa infection, but other microorganisms can also be found. The use of antibiotics is essential to treat the disease, but antibiotic performance is compromised by resistance mechanisms. Among various mechanisms of transfer of antibiotic resistance genes (ARGs), the recently been reported bacteriophages are the least explored in clinical settings. To determine the role of phages in CF as mobile genetic elements (MGEs) carrying ARGs, we evaluated their presence in 71 CF patients. 71 sputum samples taken from these patients were screened for eight ARGs (blaTEM, blaCTX-M-1-group, blaCTX-M-9-group, blaOXA-48, blaVIM, mecA, qnrA, and qnrS) in the bacteriophage DNA fraction. The phages found were also purified and observed by electron microscopy. 32.4% of CF patients harbored ARGs in phage DNA. β-lactamase genes, particularly blaVIM and blaTEM, were the most prevalent and abundant, whereas mecA, qnrA, and qnrS were very rare. Siphoviridae phage particles capable of infecting P. aeruginosa and Klebsiella pneumoniae were detected in CF sputum. Phage particles harboring ARGs were found to be abundant in the lungs of both CF patients and healthy individuals and could contribute to the colonization of multiresistant strains.
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Affiliation(s)
- Maryury Brown-Jaque
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Lirain Rodriguez Oyarzun
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Thais Cornejo-Sánchez
- Department of Clinical Microbiology, Hospital Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria T Martín-Gómez
- Department of Clinical Microbiology, Hospital Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Silvia Gartner
- Cystic Fibrosis Unit, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, CIBER of Respiratory Diseases (Ciberes CB06/06/0030), Carlos III Health Institute, Barcelona, Spain
| | - Javier de Gracia
- Cystic Fibrosis Unit, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, CIBER of Respiratory Diseases (Ciberes CB06/06/0030), Carlos III Health Institute, Barcelona, Spain
| | - Sandra Rovira
- Cystic Fibrosis Unit, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, CIBER of Respiratory Diseases (Ciberes CB06/06/0030), Carlos III Health Institute, Barcelona, Spain
| | - Antonio Alvarez
- Cystic Fibrosis Unit, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, CIBER of Respiratory Diseases (Ciberes CB06/06/0030), Carlos III Health Institute, Barcelona, Spain
| | - Joan Jofre
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Juan J González-López
- Department of Clinical Microbiology, Hospital Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maite Muniesa
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
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7
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Piedra-Carrasco N, Fàbrega A, Calero-Cáceres W, Cornejo-Sánchez T, Brown-Jaque M, Mir-Cros A, Muniesa M, González-López JJ. Carbapenemase-producing enterobacteriaceae recovered from a Spanish river ecosystem. PLoS One 2017; 12:e0175246. [PMID: 28380016 PMCID: PMC5381907 DOI: 10.1371/journal.pone.0175246] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 03/22/2017] [Indexed: 01/06/2023] Open
Abstract
The increasing resistance to carbapenems is an alarming threat in the fight against multiresistant bacteria. The dissemination properties of antimicrobial resistance genes are supported by their detection in a diverse population of bacteria, including strains isolated from the environment. The objective of this study was to investigate the presence of carbapenemase-producing Enterobacteriaceae (CPE) collected from a river ecosystem in the Barcelona metropolitan area (Spain). Identification of β-lactamases and other resistance determinants was determined as was the antimicrobial susceptibility profile. Moreover, screening of virulence factors, plasmid addiction systems, plasmid partition systems and replicon typing was performed. The results identified 8 isolates belonging to different species (Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, Klebsiella oxytoca, Raoultella ornithinolytica). The most prevalent enzyme was KPC-2 (n = 6), followed by VIM-1 (n = 2) and IMI-2 (n = 1), whereas no OXA-48-type was detected. In addition, one strain was positive for both KPC-2 and VIM-1 enzymes. All the carbapenemase-encoding plasmids carried at least one plasmid addiction or partition system, being vagCD and parAB the most frequently detected, respectively. E. coli and K. pneumoniae isolates carried a low number of virulence-associated factors and none of the detected clones has previously been identified in the clinical setting. These findings support the high dissemination potential of the carbapanemase-encoding genes and reinforce the idea that the environment is another reservoir that may play an important role in the capture, selection and dissemination of carbapenem resistance genes.
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Affiliation(s)
- Núria Piedra-Carrasco
- Department of Clinical Microbiology, Hospital Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Fàbrega
- Department of Clinical Microbiology, Hospital Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- * E-mail: (JGL); (AF)
| | - William Calero-Cáceres
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Thais Cornejo-Sánchez
- Department of Clinical Microbiology, Hospital Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maryury Brown-Jaque
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Alba Mir-Cros
- Department of Clinical Microbiology, Hospital Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maite Muniesa
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Juan José González-López
- Department of Clinical Microbiology, Hospital Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- * E-mail: (JGL); (AF)
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Coelho A, Piedra-Carrasco N, Bartolomé R, Quintero-Zarate J, Larrosa N, Cornejo-Sánchez T, Prats G, Garcillán-Barcia M, de la Cruz F, González-Lopéz J. Role of IncHI2 plasmids harbouring blaVIM-1, blaCTX-M-9, aac(6′)-Ib and qnrA genes in the spread of multiresistant Enterobacter cloacae and Klebsiella pneumoniae strains in different units at Hospital Vall d’Hebron, Barcelona, Spain. Int J Antimicrob Agents 2012; 39:514-7. [DOI: 10.1016/j.ijantimicag.2012.01.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 01/13/2012] [Accepted: 01/22/2012] [Indexed: 10/28/2022]
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