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Correa-León YP, Pérez-Hernández JM, Martinez-Guerra BA, Rodríguez-Noriega E, Mena-Ramírez JP, López-Gutiérrez E, López-Jácome LE, Monroy-Colin VA, Mireles-Davalos CD, Padilla-Ibarra C, Quevedo-Ramos MA, Feliciano-Guzmán JM, Pérez-Vicelis T, Velázquez-Acosta MDC, Hernández-Durán M, Garza-González E. Evaluation of the BD Phoenix Carbapenemase-Producing Organism Panels for the Detection of Carbapenemase Producers in Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. Diagnostics (Basel) 2023; 13:3417. [PMID: 37998553 PMCID: PMC10670751 DOI: 10.3390/diagnostics13223417] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 10/11/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/25/2023] Open
Abstract
The classification of carbapenemases can help guide therapy. The present study evaluated the performance of the CPO detection test, included in the BD Phoenix™ NMIC-501 panel for the detection and classification of carbapenemases on the representative molecularly characterized strains collection from Mexico. Carbapenem non-susceptible isolates collected in Mexico were included. The clinical isolates (n = 484) comprised Klebsiella pneumoniae (n = 154), Escherichia coli (n = 150), and P. aeruginosa (n = 180). BD Phoenix CPO NMIC-504 and NMIC-501 panels were used for the identification of species, antimicrobial susceptibility tests, and detection of CPOs. For the detection of carbapenemase-encoding genes, E. coli and K. pneumoniae were evaluated using PCR assays for blaNDM-1, blaKPC, blaVIM, blaIMP, and blaOXA-48-like. For P. aeruginosa, blaVIM, blaIMP, and blaGES were detected using PCR. Regarding E. coli, the CPO panels had a sensitivity of 70% and specificity of 83.33% for the detection of a class B carbapenemase (blaNDM in the molecular test). Regarding K. pneumoniae, the panels had a sensitivity of 75% and specificity of 100% for the detection of a class A carbapenemase (blaKPC in the molecular test). The Phoenix NMIC-501 panels are reliable for detecting class B carbapenemases in E. coli. The carbapenemase classification in K. pneumoniae for class A carbapenemases has a high specificity and PPV; thus, a positive result is of high value.
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Affiliation(s)
- Yoselin Paola Correa-León
- Departamento de Bioquímica, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey 66460, Mexico; (Y.P.C.-L.); (J.M.P.-H.)
| | - José Miguel Pérez-Hernández
- Departamento de Bioquímica, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey 66460, Mexico; (Y.P.C.-L.); (J.M.P.-H.)
| | | | - Eduardo Rodríguez-Noriega
- Hospital Civil de Guadalajara, Instituto de Patología Infecciosa y Experimental “Dr. Francisco Ruiz Sánchez”, Centro Universitario Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44280, Mexico;
| | - Juan Pablo Mena-Ramírez
- Laboratorio de Microbiología, Hospital General de Zona No. 21 IMSS Tepatitlán de Morelos, Jalisco, Centro Universitario de los Altos (Cualtos), Universidad de Guadalajara, Guadalajara 47630, Mexico;
| | - Eduardo López-Gutiérrez
- Laboratorio de Microbiología, Hospital Regional de Alta Especialidad de Oaxaca, Oaxaca de Juárez 71256, Mexico;
| | - Luis Esaú López-Jácome
- Laboratorio de Infectología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico (M.H.-D.)
| | | | - Christian Daniel Mireles-Davalos
- Laboratorio de Microbiología, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City 14080, Mexico;
| | - Cecilia Padilla-Ibarra
- Laboratorio de Microbiología, Hospital General del Estado de Sonora, Hermosillo 83249, Mexico;
| | | | | | - Talía Pérez-Vicelis
- Laboratorio de Microbiología, Hospital Regional de Alta Especialidad Bicentenario de la Independencia, Tultitlan 54916, Mexico;
| | | | - Melissa Hernández-Durán
- Laboratorio de Infectología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico (M.H.-D.)
| | - Elvira Garza-González
- Departamento de Bioquímica, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey 66460, Mexico; (Y.P.C.-L.); (J.M.P.-H.)
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Rojas-Larios F, Martínez-Guerra BA, López-Jácome LE, Bolado-Martínez E, Vázquez-Larios MDR, Velázquez-Acosta MDC, Romero-Romero D, Mireles-Dávalos CD, Quintana-Ponce S, Feliciano-Guzmán JM, Pérez-Hernandez JM, Correa-León YP, López-Gutiérrez E, Rodriguez-Noriega E, González-Díaz E, Choy-Chang EV, Mena-Ramírez JP, Monroy-Colín VA, Ponce-de-León-Garduño A, Alcaraz-Espejel M, Avilés-Benítez LK, Quintanilla-Cazares LJ, Ramírez-Alanís E, Barajas-Magallón JM, Padilla-Ibarra C, Ballesteros-Silva MB, Atanacio-Sixto NA, Morales-de-la-Peña CT, Galindo-Méndez M, Pérez-Vicelis T, Jacobo-Baca G, Moreno-Méndez MI, Mora-Pacheco MDLL, Gutiérrez-Brito M, Sánchez-Godínez XY, Navarro-Vargas NV, Mercado-Bravo LE, Delgado-Barrientos A, Santiago-Calderón MA, López-Ovilla I, Molina-Chavarria A, Rincón-Zuno J, Franco-Cendejas R, Miranda-Mauricio S, Márquez-Avalos IC, López-García M, Duarte-Miranda LS, Cetina-Umaña CM, Barroso-Herrera-Y-Cairo IE, López-Moreno LI, Garza-González E. Active Surveillance of Antimicrobial Resistance and Carbapenemase-Encoding Genes According to Sites of Care and Age Groups in Mexico: Results from the INVIFAR Network. Pathogens 2023; 12:1144. [PMID: 37764952 PMCID: PMC10537696 DOI: 10.3390/pathogens12091144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
We analyzed the antimicrobial resistance (AMR) data of 6519 clinical isolates of Escherichia coli (n = 3985), Klebsiella pneumoniae (n = 775), Acinetobacter baumannii (n = 163), Pseudomonas aeruginosa (n = 781), Enterococcus faecium (n = 124), and Staphylococcus aureus (n = 691) from 43 centers in Mexico. AMR assays were performed using commercial microdilution systems (37/43) and the disk diffusion susceptibility method (6/43). The presence of carbapenemase-encoding genes was assessed using PCR. Data from centers regarding site of care, patient age, and clinical specimen were collected. According to the site of care, the highest AMR was observed in E. coli, K. pneumoniae, and P. aeruginosa isolates from ICU patients. In contrast, in A. baumannii, higher AMR was observed in isolates from hospitalized non-ICU patients. According to age group, the highest AMR was observed in the ≥60 years age group for E. coli, E. faecium, and S. aureus, and in the 19-59 years age group for A. baumannii and P. aeruginosa. According to clinical specimen type, a higher AMR was observed in E. coli, K. pneumoniae, and P. aeruginosa isolates from blood specimens. The most frequently detected carbapenemase-encoding gene in E. coli was blaNDM (84%).
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Affiliation(s)
- Fabian Rojas-Larios
- Laboratorio de Microbiología, Hospital Regional Universitario de Colima, Colima 28040, Mexico
| | - Bernardo Alfonso Martínez-Guerra
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México 14080, Mexico
| | - Luis Esaú López-Jácome
- Servicio de Infectología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico
| | - Enrique Bolado-Martínez
- Departamento de Ciencias Químico-Biológicas, Universidad de Sonora, Hermosillo 83000, Mexico
| | - María Del Rosario Vázquez-Larios
- Laboratorio de Microbiología, Servicio de Infectología y Microbiología Cínica, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico
| | | | | | - Christian Daniel Mireles-Dávalos
- Laboratorio de Microbiología Clínica, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City 14080, Mexico
| | - Sandra Quintana-Ponce
- Facultad de Ciencias Naturales, Universidad Autónoma de Guerrero, Chilpancingo 39000, Mexico
| | | | - José Miguel Pérez-Hernandez
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey 66460, Mexico
| | - Yoselin Paola Correa-León
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey 66460, Mexico
| | - Eduardo López-Gutiérrez
- Área de Microbiología, Laboratorio Clínico, Hospital Regional de alta Especialidad de Oaxaca, Oaxaca 71256, Mexico
| | - Eduardo Rodriguez-Noriega
- Instituto de Patología Infecciosa y Experimental, Centro Universitario Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44280, Mexico
| | - Esteban González-Díaz
- Instituto de Patología Infecciosa y Experimental, Centro Universitario Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44280, Mexico
- Departamento de Medicina Preventiva, Hospital Civil de Guadalajara, Fray Antonio Alcalde, Guadalajara 44280, Mexico
| | - Elena Victoria Choy-Chang
- Departamento de Bacteriología, Hospital General de Zona No.1 IMSS "Nueva Frontera", Tapachula 30767, Mexico
| | - Juan Pablo Mena-Ramírez
- Laboratorio de Microbiología, Hospital General de Zona No. 21 IMSS, Centro Universitario de los Altos (CUALTOS), Universidad de Guadalajara, Tepatitlán de Morelos 47630, Mexico
| | | | - Alfredo Ponce-de-León-Garduño
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México 14080, Mexico
| | | | - Laura Karina Avilés-Benítez
- Laboratorio de Microbiología y Parasitología, Hospital Infantil de Morelia "Eva Sámano de López Mateos", Morelia 58253, Mexico
| | | | | | | | - Cecilia Padilla-Ibarra
- Laboratorio Clínico, Hospital General de Estado "Dr. Ernesto Ramos Bours", Hermosillo 83000, Mexico
| | | | | | | | | | - Talía Pérez-Vicelis
- Hospital Regional de Alta Especialidad Bicentenario de la Independencia, Tultitlán 54916, Mexico
| | - Guillermo Jacobo-Baca
- Centro Universitario de Salud, Universidad Autónoma de Nuevo León, Monterrey 66460, Mexico
| | | | | | | | | | | | | | | | | | - Ismelda López-Ovilla
- Hospital Chiapas Nos Une Dr. Jesús Gilberto Gómez Maza, Tuxtla Gutiérrez 29045, Mexico
| | | | - Joaquín Rincón-Zuno
- Instituto Materno Infantil del Estado de México, Toluca de Lerdo 50170, Mexico
| | - Rafael Franco-Cendejas
- Servicio de Infectología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico
| | | | | | - Maribel López-García
- Hospital de la Madre y el Niño Guerrerense, Chilpancingo de los Bravo 39075, Mexico
| | | | | | | | | | - Elvira Garza-González
- Departamento de Bioquímica y Medicina Molecular, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey 66460, Mexico
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Garza-Ramos U, Rodríguez-Medina N, Córdova-Fletes C, Rubio-Mendoza D, Alonso-Hernández CJ, López-Jácome LE, Morfín-Otero R, Rodríguez-Noriega E, Rojas-Larios F, Vázquez-Larios MDR, Ponce-de-Leon A, Choy-Chang EV, Franco-Cendejas R, Martinez-Guerra BA, Morales-de-La-Peña CT, Mena-Ramírez JP, López-Gutiérrez E, García-Romo R, Ballesteros-Silva B, Valadez-Quiroz A, Avilés-Benítez LK, Feliciano-Guzmán JM, Pérez-Vicelis T, Velázquez-Acosta MDC, Padilla-Ibarra C, López-Moreno LI, Corte-Rojas RE, Couoh-May CA, Quevedo-Ramos MA, López-García M, Chio-Ortiz G, Gil-Veloz M, Molina-Chavarria A, Mora-Domínguez JP, Romero-Romero D, May-Tec FJ, Garza-González E. Whole genome analysis of Gram-negative bacteria using the EPISEQ CS application and other bioinformatic platforms. J Glob Antimicrob Resist 2023; 33:61-71. [PMID: 36878463 DOI: 10.1016/j.jgar.2023.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 12/22/2022] [Revised: 02/23/2023] [Accepted: 02/26/2023] [Indexed: 03/07/2023] Open
Abstract
OBJECTIVES To determine genomic characteristics and molecular epidemiology of carbapenem non-susceptible Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii, and Pseudomonas aeruginosa from medical centres of Mexico using whole genome sequencing data analysed with the EPISEQⓇ CS application and other bioinformatic platforms. METHODS Clinical isolates collected from 28 centres in Mexico included carbapenem-non-susceptible K. pneumoniae (n = 22), E. coli (n = 24), A. baumannii (n = 16), and P. aeruginosa (n = 13). Isolates were subjected to whole genome sequencing using the Illumina (MiSeq) platform. FASTQ files were uploaded to the EPISEQⓇ CS application for analysis. Additionally, the tools Kleborate v2.0.4 and Pathogenwatch were used as comparators for Klebsiella genomes, and the bacterial whole genome sequence typing database was used for E. coli and A. baumannii. RESULTS For K. pneumoniae, both bioinformatic approaches detected multiple genes encoding aminoglycoside, quinolone, and phenicol resistance, and the presence of blaNDM-1 explained carbapenem non-susceptibility in 18 strains and blaKPC-3 in four strains. Regarding E. coli, both EPISEQⓇ CS and bacterial whole genome sequence typing database analyses detected multiple virulence and resistance genes: 20 of 24 (83.3%) strains carried blaNDM, 3 of 24 (12.4%) carried blaOXA-232, and 1 carried blaOXA-181. Genes that confer resistance to aminoglycosides, tetracyclines, sulfonamides, phenicols, trimethoprim, and macrolides were also detected by both platforms. Regarding A. baumannii, the most frequent carbapenemase-encoding gene detected by both platforms was blaOXA-72, followed by blaOXA-66. Both approaches detected similar genes for aminoglycosides, carbapenems, tetracyclines, phenicols, and sulfonamides. Regarding P. aeruginosa, blaVIM, blaIMP, and blaGES were the more frequently detected. Multiple virulence genes were detected in all strains. CONCLUSION Compared to the other available platforms, EPISEQⓇ CS enabled a comprehensive resistance and virulence analysis, providing a reliable method for bacterial strain typing and characterization of the virulome and resistome.
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Affiliation(s)
| | | | | | - Daira Rubio-Mendoza
- Facultad de Medicina, Universidad Autónoma de Nuevo León, Nuevo León, Mexico
| | | | | | - Rao Morfín-Otero
- Hospital Civil de Guadalajara Fray Antonio Alcalde, Universidad de Guadalajara, Jalisco, Mexico
| | | | | | | | - Alfredo Ponce-de-Leon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de Mexico, Mexico
| | | | | | | | | | - Juan Pablo Mena-Ramírez
- Hospital General de Zona No. 21, IMSS. Centro Universitario de los Altos, Universidad de Guadalajara. Jalisco, Mexico
| | | | | | | | | | | | | | - Talia Pérez-Vicelis
- Hospital Regional de alta especialidad Bicentenario de la independencia, Estado de México, Mexico
| | | | | | | | | | | | | | | | | | - Mariana Gil-Veloz
- Hospital Regional de Alta Especialidad del Bajío, Guanajuato, Mexico
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Garza-González E, Camacho-Ortiz A, Ponce-de-Leon A, Ortiz-Brizuela E, López-Jácome LE, Colin C, Rojas-Larios F, Newton-Sánchez OA, Echaniz-Aviles G, Carnalla-Barajas MN, Soto A, Bocanegra-Ibarias P, Hernández-Dueñas AMDR, Velázquez-Acosta MDC, Avilés-Benítez LK, Mena-Ramirez JP, Romero D, Mora-Jiménez I, Alcaraz-Espejel M, Feliciano-Guzmán JM, López-García M, Rodriguez-Zulueta P, Quevedo-Ramos MA, Padilla-Ibarra C, Couoh-May CA, Rivera-Ferreira MC, Morales-de-la-Peña CT, Zubiate H, Peralta-Catalán R, Cetina-Umaña CM, Rincón-Zuno J, Perez-Ricardez ML, Hernández-Cordova IY, López-Gutiérrez E, Gil M, Aguirre-Burciaga E, Huirache-Villalobos GS, Munoz S, Barlandas-Rendón NRE, Bolado-Martinez E, Quintanilla-Cazares LJ, Gómez-Choel AC, Lopez L, Tinoco JC, Martínez-Gamboa RA, Molina A, Escalante-Armenta SP, Duarte L, Ruiz-Gamboa LA, Cobos-Canul DI, López D, Barroso-Herrera-y-Cairo IE, Rodriguez-Noriega E, Morfin-Otero R. Bacterial incidence and drug resistance from pathogens recovered from blood, cerebrospinal and pleural fluids in 2019-2020. Results of the Invifar network. PeerJ 2023; 11:e14411. [PMID: 36684666 PMCID: PMC9854381 DOI: 10.7717/peerj.14411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/27/2022] [Indexed: 01/18/2023] Open
Abstract
Background Antimicrobial resistance is a global concern. Analysis of sterile fluids is essential because microorganisms are defined as significant in most cases. Blood, cerebrospinal, and pleural fluids are frequently received in the microbiology lab because they are associated with considerable rates of morbi-mortality. Knowledge of epidemiology in these samples is needed to choose proper empirical treatments due to the importance of reducing selection pressure. Methods We used retrospective laboratory data of blood, CSF, and pleural fluid collected from patients in Mexico between 2019 and 2020. Each laboratory identified the strains and tested susceptibility using its routine methods. For Streptococcus pneumoniae, a comparative analysis was performed with data from the broth microdilution method. Results Forty-five centers participated in the study, with 30,746 clinical isolates from blood, 2,429 from pleural fluid, and 2,275 from CSF. For blood and CSF, Staphylococcus epidermidis was the most frequent. For blood, among gram negatives, the most frequent was Escherichia coli. Among Enterobacterales, 9.8% of K. pneumoniae were carbapenem-resistant. For S. pneumoniae, similar resistance percentages were observed for levofloxacin, cefotaxime, and vancomycin. For CSF, the most frequent gram-negative was E. coli. In Acinetobacter baumannii, carbapenem resistance was 71.4%. The most frequent species detected for pleural fluid was E. coli; in A. baumannii, carbapenem resistance was 96.3%. Conclusion Gram-negative bacteria, with E. coli most prevalent, are frequently recovered from CSF, blood, and pleural fluid. In S. pneumoniae, the routine, conventional methods showed good agreement in detecting resistance percentages for erythromycin, levofloxacin, and vancomycin.
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Affiliation(s)
- Elvira Garza-González
- Facultad de Medicina, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Adrian Camacho-Ortiz
- Facultad de Medicina, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Alfredo Ponce-de-Leon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Edgar Ortiz-Brizuela
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Claudia Colin
- Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Fabian Rojas-Larios
- Facultad de Medicina, Universidad de Colima and Hospital Regional Universitario de los Servicios de Salud del Estado de Colima, Colima, Mexico
| | - Oscar A. Newton-Sánchez
- Facultad de Medicina, Universidad de Colima and Hospital Regional Universitario de los Servicios de Salud del Estado de Colima, Colima, Mexico
| | | | | | - Araceli Soto
- Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Paola Bocanegra-Ibarias
- Facultad de Medicina, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | | | | | | | - Juan Pablo Mena-Ramirez
- Hospital General de Zona No.21 IMSS, Centro Universitario de los Altos (CUALTOS), Universidad de Guadalajara, Guadalajara, Mexico
| | - Daniel Romero
- Análisis Bioquímico Clínicos “Louis Pasteur”, Toluca, Mexico
| | | | | | | | | | | | | | | | | | | | | | - Hector Zubiate
- Hospital General Lázaro Cárdenas, ISSSTE, Chihuahua, Mexico
| | | | | | | | | | | | | | - Mariana Gil
- Hospital Regional de Alta Especialidad del Bajío, Leon, Mexico
| | | | | | | | | | | | | | | | | | | | | | | | | | - Lizbeth Duarte
- Centro Integral de Atención a la Salud Sur ISSSTESON, Hermosillo, Mexico
| | | | | | - Dulce López
- Hospital Lic. Adolfo López Mateos, Ciudad Obregón, Mexico
| | | | - Eduardo Rodriguez-Noriega
- Hospital Civil de Guadalajara Fray Antonio Alcalde, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Rayo Morfin-Otero
- Hospital Civil de Guadalajara Fray Antonio Alcalde, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
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Garza-Ramos U, Silva-Sánchez J, López-Jácome LE, Hernández-Durán M, Colín-Castro CA, Sánchez-Pérez A, Rodríguez-Santiago J, Morfín-Otero R, Rodriguez-Noriega E, Velázquez-Acosta MDC, Vázquez-Larios MDR, Feliciano-Guzmán JM, Rojas-Larios F, Ponce-De-Leon A, Lozano-Garcia M, Choy-Chang EV, López-Gutiérrez E, Molina-Jaimes A, Gil-Veloz M, Corte-Rojas RE, López-Ovilla I, Ramirez-Mis JL, Rodríguez-Balderas DE, Molina-Chavarria A, Padilla-Ibarra C, Quevedo-Ramos MA, Mireles-Dávalos CD, Rodríguez-Medina N, Rubio-Mendoza D, Córdova-Fletes C, Cruz-López F, Becerra-Montejano DA, Mercado-Longoria R, Martínez-Villarreal RT, Barlandas-Rendón NRE, Mena-Ramírez JP, Couoh-May CA, Alcaraz-Espejel M, Adame-Alvarez C, Hernández-Vicente L, Garza-González E. Carbapenemase-Encoding Genes and Colistin Resistance in Gram-Negative Bacteria During the COVID-19 Pandemic in Mexico: Results from the Invifar Network. Microb Drug Resist 2022. [PMID: 36595348 DOI: 10.1089/mdr.2022.0226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
In this study, we report the carbapenemase-encoding genes and colistin resistance in Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa in the second year of the COVID-19 pandemic. Clinical isolates included carbapenem-resistant K. pneumoniae, carbapenem-resistant E. coli, carbapenem-resistant A. baumannii, and carbapenem-resistant P. aeruginosa. Carbapenemase-encoding genes were detected by PCR. Carbapenem-resistant K. pneumoniae and carbapenem-resistant E. coli isolates were analyzed using the Rapid Polymyxin NP assay. mcr genes were screened by PCR. Pulsed-field gel electrophoresis and whole-genome sequencing were performed on representative isolates. A total of 80 carbapenem-resistant E. coli, 103 carbapenem-resistant K. pneumoniae, 284 carbapenem-resistant A. baumannii, and 129 carbapenem-resistant P. aeruginosa isolates were recovered. All carbapenem-resistant E. coli and carbapenem-resistant K. pneumoniae isolates were included for further analysis. A selection of carbapenem-resistant A. baumannii and carbapenem-resistant P. aeruginosa strains was further analyzed (86 carbapenem-resistant A. baumannii and 82 carbapenem-resistant P. aeruginosa). Among carbapenem-resistant K. pneumoniae and carbapenem-resistant E. coli isolates, the most frequent gene was blaNDM (86/103 [83.5%] and 72/80 [90%], respectively). For carbapenem-resistant A. baumannii, the most frequently detected gene was blaOXA-40 (52/86, 60.5%), and for carbapenem-resistant P. aeruginosa, was blaVIM (19/82, 23.2%). For carbapenem-resistant A. baumannii, five indistinguishable pulsotypes were detected. Circulation of K. pneumoniae New Delhi metallo-β-lactamase (NDM) and E. coli NDM was detected in Mexico. High virulence sequence types (STs), such as K. pneumoniae ST307, E. coli ST167, P. aeruginosa ST111, and A. baumannii ST2, were detected. Among K. pneumoniae isolates, 18/101 (17.8%) were positive for the Polymyxin NP test (two, 11.0% positive for the mcr-1 gene, and one, 5.6% with disruption of the mgrB gene). All E. coli isolates were negative for the Polymyxin NP test. In conclusion, K. pneumoniae NDM and E. coli NDM were detected in Mexico, with the circulation of highly virulent STs. These results are relevant in clinical practice to guide antibiotic therapies considering the molecular mechanisms of resistance to carbapenems.
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Affiliation(s)
| | | | - Luis Esaú López-Jácome
- Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, Mexico
| | | | | | | | | | - Rayo Morfín-Otero
- Hospital Civil de Guadalajara Fray Antonio Alcalde, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Eduardo Rodriguez-Noriega
- Hospital Civil de Guadalajara Fray Antonio Alcalde, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | | | | | | | - Fabián Rojas-Larios
- Laboratorio de Ecología y Microbiología, Facultad de Medicina, Universidad de Colima, Colima, Mexico
| | - Alfredo Ponce-De-Leon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de Mexico, Mexico
| | | | | | | | - Aarón Molina-Jaimes
- Hospital Regional de Alta Especialidad Bicentenario de la Independencia, Tultitlán de Mariano Escobedo, Estado de México, Mexico
| | - Mariana Gil-Veloz
- Hospital Regional de Alta Especialidad del Bajío, Leon, Guanajuato, Mexico
| | | | | | | | | | | | | | | | | | | | - Daira Rubio-Mendoza
- Facultad de Medicina, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Carlos Córdova-Fletes
- Facultad de Medicina, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Flora Cruz-López
- Facultad de Ciencias Químicas, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | | | - Roberto Mercado-Longoria
- Facultad de Medicina, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | | | | | - Juan Pablo Mena-Ramírez
- Hospital General de Zona N. 21 IMSS, Centro Universitario de los Altos CUALTOS, Tepatitlán de Morelos, Jalisco, Mexico
| | | | | | | | | | - Elvira Garza-González
- Facultad de Medicina, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
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López-Jácome LE, Fernández-Rodríguez D, Franco-Cendejas R, Camacho-Ortiz A, Morfin-Otero MDR, Rodríguez-Noriega E, Ponce-de-León A, Ortiz-Brizuela E, Rojas-Larios F, Velázquez-Acosta MDC, Mena-Ramírez JP, Rodríguez-Zulueta P, Bolado-Martínez E, Quintanilla-Cazares LJ, Avilés-Benítez LK, Consuelo-Munoz S, Choy-Chang EV, Feliciano-Guzmán JM, Couoh-May CA, López-Gutiérrez E, Molina-Jaimes A, Rincón-Zuno J, Gil-Veloz M, Alcaraz-Espejel M, Corte-Rojas RE, Gómez-Espinosa J, Monroy-Colin VA, Morales-de-la-Peña CT, Aguirre-Burciaga E, López-Moreno LI, Martínez-Villarreal RT, Cetina-Umaña CM, Galindo-Méndez M, Soto-Nieto GI, Cobos-Canul DI, Moreno-Méndez MI, Tello-Gómez E, Romero-Romero D, Quintana-Ponce S, Peralta-Catalán R, Valadez-Quiroz A, Molina-Chavarría A, Padilla-Ibarra C, Barroso-Herrera-Y-Cairo IE, Duarte-Miranda LS, López-López DM, Escalante-Armenta SP, Osorio-Guzmán MJ, López-García M, Garza-Ramos U, Delgado-Enciso I, Garza-González E. Increment Antimicrobial Resistance During the COVID-19 Pandemic: Results from the Invifar Network. Microb Drug Resist 2022; 28:338-345. [PMID: 34870473 DOI: 10.1089/mdr.2021.0231] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Aim: This study aims to assess the changes in antimicrobial resistance among some critical and high-priority microorganisms collected previously and during the coronavirus disease 2019 (COVID-19) pandemic in Mexico. Methods: We collected antimicrobial susceptibility data for critical and high-priority microorganisms from blood, urine, respiratory samples, and from all specimens, in which the pathogen may be considered a causative agent. Data were stratified and compared for two periods: 2019 versus 2020 and second semester 2019 (prepandemic) versus the second semester 2020 (pandemic). Results: In the analysis of second semester 2019 versus the second semester 2020, in blood samples, increased resistance to oxacillin (15.2% vs. 36.9%), erythromycin (25.7% vs. 42.8%), and clindamycin (24.8% vs. 43.3%) (p ≤ 0.01) was detected for Staphylococcus aureus, to imipenem (13% vs. 23.4%) and meropenem (11.2% vs. 21.4) (p ≤ 0.01), for Klebsiella pneumoniae. In all specimens, increased ampicillin and tetracycline resistance was detected for Enterococcus faecium (p ≤ 0.01). In cefepime, meropenem, levofloxacin, and gentamicin (p ≤ 0.01), resistance was detected for Escherichia coli; and in piperacillin-tazobactam, cefepime, imipenem, meropenem, ciprofloxacin, levofloxacin, and gentamicin (p ≤ 0.01), resistance was detected for Pseudomonas aeruginosa. Conclusion: Antimicrobial resistance increased in Mexico during the COVID-19 pandemic. The increase in oxacillin resistance for S. aureus and carbapenem resistance for K. pneumoniae recovered from blood specimens deserves special attention. In addition, an increase in erythromycin resistance in S. aureus was detected, which may be associated with high azithromycin use. In general, for Acinetobacter baumannii and P. aeruginosa, increasing resistance rates were detected.
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Affiliation(s)
- Luis Esaú López-Jácome
- División de Infectología, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra," Ciudad de México, Mexico
| | - Diana Fernández-Rodríguez
- División de Infectología, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra," Ciudad de México, Mexico
| | - Rafael Franco-Cendejas
- División de Infectología, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra," Ciudad de México, Mexico
| | - Adrián Camacho-Ortiz
- Infectología, Facultad de Medicina, Hospital Universitario Dr. José Eleuterio González. Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - María Del Rayo Morfin-Otero
- Infectología, Hospital Civil De Guadalajara Fray Antonio Alcalde, Universidad de Guadalajara, Guadalajara, Mexico
| | - Eduardo Rodríguez-Noriega
- Infectología, Hospital Civil De Guadalajara Fray Antonio Alcalde, Universidad de Guadalajara, Guadalajara, Mexico
| | - Alfredo Ponce-de-León
- Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de Mexico, Mexico
| | - Edgar Ortiz-Brizuela
- Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de Mexico, Mexico
| | - Fabian Rojas-Larios
- Laboratorio de Ecología y Microbiología, Facultad de Medicina, Universidad de Colima, Colima, Mexico
| | | | - Juan Pablo Mena-Ramírez
- Laboratorio, Hospital General de Zona No. 21 IMSS and Centro Universitario de los Altos (CUALTOS), Universidad de Guadalajara, Tepatitlán De Morelos, Mexico
| | | | | | | | - Laura Karina Avilés-Benítez
- Laboratorio de Microbiología y Parasitología, Hospital Infantil de Morelia "Eva Sámano De López Mateos," Morelia, Mexico
| | | | - Elena Victoria Choy-Chang
- Laboratorio de análisis clínicos Departamento de bacteriología, Hospital General de Zona No.1 IMSS Nueva Frontera, Tapachula, Mexico
| | | | | | - Eduardo López-Gutiérrez
- Laboratorio de Microbiología, Hospital Regional de Alta Especialidad de Oaxaca, San Bartolo Coyotepec, Mexico
| | - Aarón Molina-Jaimes
- Infectología y Unidad de Vigilancia Epidemiológica Hospitalaria, Hospital Regional de Alta Especialidad Bicentenario de la Independencia, Tultitlán de Mariano Escobedo, Mexico
| | | | - Mariana Gil-Veloz
- Servicios Clínicos, Hospital Regional de Alta Especialidad del Bajío, León, Mexico
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Sandra Quintana-Ponce
- Laboratorio Clínico, Escuela Superior de Ciencias Naturales, Universidad Autónoma de Guerrero, Guerrero, Mexico
| | - Raúl Peralta-Catalán
- Laboratorio Clínico, Hospital General Dr. Raymundo Abarca Alarcón, Chilpancingo de los Bravo, Mexico
| | | | | | - Cecilia Padilla-Ibarra
- Laboratorio Clínico, Hospital General del Estado, Dr. Ernesto Ramos Bours, Hermosillo, Mexico
| | | | | | | | | | | | - Maribel López-García
- Laboratorio de Análisis Clínicos, Hospital de la Madre y el Niño Guerrerense, Chilpancingo de los Bravo, Mexico
| | - Ulises Garza-Ramos
- Laboratorio de Resistencia Bacteriana, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Iván Delgado-Enciso
- Laboratorio de Ecología y Microbiología, Facultad de Medicina, Universidad de Colima, Colima, Mexico
| | - Elvira Garza-González
- Bioquímica y Medicina Molecular, Facultad de Medicina, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico
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