Emerging carbapenem-resistant Aeromonas spp. infections in Cali, Colombia

Rosso, Fernando; Cedano, Jorge; Parra-Lara, Luis Gabriel; Sanz, A.; Toala, Alejandra; Velez, Jolian Fernando; Hormaza, María Paula; Moncada, Pablo Andrés; Correa, Adriana

doi:10.1016/j.bjid.2019.08.005

Cited by 25 publications

(24 citation statements)

References 25 publications

(27 reference statements)

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“…Here we report the first cases of CphA-mediated carbapenem resistant A. hydrophila in the United States. The majority of CphA-mediated carbapenem resistance has been detected in soil or water environments in Asia and Europe (Walsh et al, 1997;Balsalobre et al, 2009;Piotrowska et al, 2017;Piccirilli et al, 2019), but also found in human infections as severe as bacteremia reported from Taiwan (Wu et al, 2007(Wu et al, , 2011(Wu et al, , 2012, Australia (Sinclair et al, 2016), and Colombia (Rosso et al, 2019). The idea that MDR organisms from the environment cause human infection is not novel; however, what is highlighted in this case is that current phenotypic methods are limited in correctly detecting carbapenem resistance in Aeromonas species.…”

Section: Discussionmentioning

confidence: 92%

“…CphA is also found in other clinically relevant Aeromonas species: A. bestiarum, A. caviae, A. sobria, A. veronii, and A. jandaei (Rossolini et al, 1995). Disseminated infections by CphA carrying A. hydrophila, primarily bacteremia, have mainly been reported in Asian and South American countries including Taiwan (Wu et al, 2007(Wu et al, , 2011(Wu et al, , 2012, Australia (Sinclair et al, 2016), and Colombia (Rosso et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

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Carbapenem Resistant Aeromonas hydrophila Carrying blacphA7 Isolated From Two Solid Organ Transplant Patients

Hilt

Fitzwater

Ward

et al. 2020

Front. Cell. Infect. Microbiol.

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Aeromonas hydrophila resides in a variety of aquatic environments. Infections with A. hydrophila mainly occur after contact with fresh or brackish water. Nosocomial infections with A. hydrophila can also occur. A. hydrophila infections can be difficult to treat due to both intrinsic and acquired antimicrobial resistance (AMR) mechanisms. In 2018-19, we isolated multi-drug resistant (MDR) A. hyrodphila from two solid organ transplant patients with intra-abdominal infections. We aimed to characterize their AMR mechanisms and to determine their genetic relatedness to aid epidemiological investigation. We performed whole genome sequencing (WGS) using Illumina MiSeq and Nanopore MinIon on 3 A. hydrophila isolates, with one isolate from Patient A (blood) and two isolates from Patient B (abdominal and T-tube fluid, isolated 2 weeks apart). Phenotypic assays included: Broth Microdilution (BMD), Modified Hodge Test (MHT), Modified Carbapenem Inactivation Method (mCIM), and EDTA Carbapenem Inactivation Method (eCIM). Data analyses were performed using CLCbio and Geneious. AMR genomic analysis revealed that all three isolates possess chromosomally encoded genes including bla OXA−12 (oxacillinase), bla cepS (AmpC), and bla cphA7 (metallo-beta-lactamase). All isolates tested strongly positive by MHT and mCIM, but only Patient B's second isolate (after 2 weeks of meropenem treatment) tested positive by eCIM. More intriguingly, Patient B's first isolate (before meropenem treatment) tested falsely susceptible to carbapenems by BMD, suggesting bla cphA7 gene was not expressed constitutively. Phylogenetic analysis showed the two isolates from Patient B were highly similar with only 1 SNP difference. The isolate from Patient A only differed from Patient B's isolates by 35 and 36 SNPs, respectively, suggesting close genetic relatedness. Further epidemiological investigation is undergoing. We report the first cases of CphA-mediated carbapenem resistant A. hydrophila in the U.S. It is concerning that 1 out of 3 isolates tested falsely susceptible to carbapenems by BMD despite clear carbapenemase production shown by strongly positive MHT and mCIM. In both cases, meropenem was initially used to treat the patients. Clinicians and microbiologists in the US should be aware of the emerging MDR Aeromonas nosocomial infections and the potential false carbapenem susceptible results due to CphA-type carbapenemase, which may be induced during treatment.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Carbapenem Resistant Aeromonas hydrophila Carrying blacphA7 Isolated From Two Solid Organ Transplant Patients

Hilt

Fitzwater

Ward

et al. 2020

Front. Cell. Infect. Microbiol.

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“…Human infections caused by Carbapenem resistant Aeromonas spp. have been reported in the recent past in Colombia and in United States [68,69]. Carbapenem resistance has been associated with the production of carbapenems hydrolyzing Aeromonas (CphA).…”

Section: Discussionmentioning

confidence: 99%

Characterization and Antimicrobial Resistance of Environmental and Clinical Aeromonas Species Isolated from Fresh Water Ornamental Fish and Associated Farming Environment in Sri Lanka

Dhanapala

Kalupahana

et al. 2021

Microorganisms

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The aims of this study were to characterize and investigate antimicrobial susceptibility and presence of integrons in 161 Aeromonas spp. isolated from ornamental freshwater fish farming environment, apparently healthy and diseased fish. Phylogenetic analyses of the gyrB gene sequences identified Aeromonas veronii as the most abundant species (75.8%) followed by Aeromonas hydrophila (9.3%), Aeromonas caviae (5%), Aeromonas jandaei (4.3%), Aeromonas dhakensis (3.7%), Aeromonas sobria (0.6%), Aeromonas media (0.6%), and Aeromonas popoffii (0.6%). Susceptibility to thirteen antimicrobials was determined and antimicrobial resistance frequencies were: amoxicillin (92.5%), enrofloxacin (67.1%), nalidixic acid (63.4%), erythromycin (26.1%), tetracycline (23.6%), imipenem (18%), trimethoprim-sulfamethoxazole (16.8%), and gentamicin (16.8%). Multi-drug resistance (MDR) was widespread among the isolates (51.6%, 83/161) with 51.6% (63/122) A. veronii isolates being MDR. In addition, 68.3% of isolates had multiple antibiotic resistance (MAR) indexes higher than 0.2, suggesting that they originated from a high-risk source of contamination where antimicrobials are often used. In all, 21.7% isolates carried class 1 integrons, with 97.1% having gene cassettes, while there were 12 isolates carrying class 2 integron gene cassettes. Our findings highlight that the aquatic environment and ornamental fish act as reservoirs of multidrug resistant Aeromonas spp. and underline the need for a judicious use of antimicrobials and timely surveillance of antimicrobial resistance (AMR) in aquaculture.

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“…The low bacterial resistance to ertapenem might be due to its relatively new administration and low rate of prescription for infectious illness. Studies in Ethiopia and Colombia also reported low resistance to ertapenem [40,41].…”

Section: Antibiotic Nonsusceptibilitymentioning

confidence: 99%

Antimicrobial Resistance Profiles for Different Isolates in Aden, Yemen: A Cross-Sectional Study in a Resource-Poor Setting

Badulla

Alshakka

Ibrahim

2020

BioMed Research International

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Background. There is a rapid deterioration in the effectiveness of antibiotics due to the global prevalence of bacterial antimicrobial resistance (AMR). AMR can cause an increase in mortality and morbidity due to treatment failures and a lack of effective therapy. Objective. The purpose of this study was to evaluate the AMR pattern of different bacterial isolates at hospitals and laboratories. Materials and Methods. A cross-sectional study from March 2019 to June 2019 was conducted at different governmental and private hospitals and laboratories in Aden, Yemen. Age, sex, specimen type, bacterial isolates, and antibiotic susceptibility pattern were collected using a data extraction sheet. Descriptive statistics were used for data analysis. Result. Data were recorded for 412 patients from whom 20 clinical specimens were collected and analyzed. The most common bacteria isolated were Staphylococcus spp. (n=172, 41.74%), E. coli (n=164, 39.80%), Pseudomonas spp. (n=37, 8.98%), and Klebsiella pneumoniae (n=18, 4.36%); other bacteria were less common. The overall bacterial resistance was highest against the combination of sulfamethoxazole with trimethoprim (73.12%), followed by amoxicillin and clavulanate (65.19%). The cephalosporin antibiotics also showed high resistance rates. The study also showed moderate bacterial resistance to gentamycin (32.65%), azithromycin (29.92%), cefoxitin (62.65%), and ciprofloxacin (25.60%). Ertapenem (16.67%) and levofloxacin (15.56%) had the lowest resistance rates. Conclusion. There was a high percentage of bacteria resistant to several antibiotics. Antibiotic susceptibility testing is a prerequisite guide for the selection of appropriate antibiotic therapy for bacterial infections.

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Emerging carbapenem-resistant Aeromonas spp. infections in Cali, Colombia

Cited by 25 publications

References 25 publications

Carbapenem Resistant Aeromonas hydrophila Carrying blacphA7 Isolated From Two Solid Organ Transplant Patients

Carbapenem Resistant Aeromonas hydrophila Carrying blacphA7 Isolated From Two Solid Organ Transplant Patients

Characterization and Antimicrobial Resistance of Environmental and Clinical Aeromonas Species Isolated from Fresh Water Ornamental Fish and Associated Farming Environment in Sri Lanka

Antimicrobial Resistance Profiles for Different Isolates in Aden, Yemen: A Cross-Sectional Study in a Resource-Poor Setting

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