Earliest identification of New Delhi metallo-β-lactamase 1 (NDM-1) in Acinetobacter pittii in Brazil

Deglmann, Roseneide Campos; Kobs, Vanessa Cristine; Oliveira, Débora de; Burgardt, Patricia; França, Paulo Henrique Condeixa de; Pillonetto, Marcelo

doi:10.1590/0037-8682-0348-2018

Cited by 7 publications

(3 citation statements)

References 10 publications

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“…Toledo et al (29) described that Carbapenem-Resistant A. baumannii (CRAB) was responsible for 34.5 to 36.2% of hospital-acquired pneumonia during the years of 2010 to 2011. bla OXA−23−like is highly expressed amongst the Brazilian CRAB population, being present in up to 100% of isolates (37), as well as in all Latin America (35). Along with OXA-23-like, NDM has also been detected in Brazilian Acinetobacter spp (38,39). Consequently, the sum of these multiple resistance-conferring factors creates a scenario in which Acinetobacter resistance is poised to maintain its progressive expansion.…”

Section: The Eskape Group-acinetobacter Baumanniimentioning

confidence: 99%

The Experience of Implementing a National Antimicrobial Resistance Surveillance System in Brazil

Pillonetto

Jordão

Andraus

et al. 2021

Front. Public Health

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Antimicrobial resistance (AMR) is a major public health threat of global proportions, which has the potential to lead to approximately ten million deaths per year by 2050. Pressured by this wicked problem, in 2014, the World Health Organization launched a call for member states to share AMR data through the implementation of the Global Antimicrobial Resistance Surveillance System (GLASS), to appropriately scale and monitor the general situation world-widely. In 2017, Brazil joined GLASS and, in 2018, started its own national antimicrobial surveillance program (BR-GLASS) to understand the impact of resistance in the country. We compiled data obtained from the complete routine of three hospitals' microbiology labs during the year of 2018. This pilot data sums up to 200,874 antimicrobial susceptibility test results from 11,347 isolates. It represents 119 different microorganisms recovered from 44 distinct types of clinical samples. Specimens came from patients originating from 301 Brazilian cities, with 4,950 of these isolates from presumed Healthcare-Associated Infections (HAIs) and the other 6,397 community-acquired cases. The female population offered 58% of the collected samples, while the other 42% were of male origin. The urinary tract was the most common topography (6,372/11,347 isolates), followed by blood samples (2,072/11,347). Gram-negative predominated the bacterial isolates: Escherichia coli was the most prevalent in general, representing 4,030 isolates (89.0% of these from the urinary tract). Coagulase-negative Staphylococci were the most prevalent bacteria in blood samples. Besides these two species, the ESKAPE group have consolidated their prevalence. Regarding drug susceptibility results, 141,648 (70.5%) were susceptible, 9,950 (4.9%) intermediate, and 49,276 (24.5%) resistant. Acinetobacter baumannii was the most worrisome microorganism, with 65.3% of the overall antimicrobial susceptibility tests showing resistance, followed by ESBL-producing Klebsiella pneumoniae, with a global resistance rate of 59%. Although this is a pilot project (still limited to one state), this database shows the importance of a nation-wide surveillance program,[153mm][-12mm] Q14 especially considering it already had patients coming from 301 distinct counties and 18 different states. The BR-GLASS Program is an ongoing project that intends to encompass at least 95 hospitals distributed in all five geographical regions in Brazil within the next 5 years.

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Section: The Eskape Group-acinetobacter Baumanniimentioning

confidence: 99%

The Experience of Implementing a National Antimicrobial Resistance Surveillance System in Brazil

Pillonetto

Jordão

Andraus

et al. 2021

Front. Public Health

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“…The major mechanisms of resistance in CRAP found in Thailand include production of OXA-23 and OXA-58 [ 7 , 8 ]. Apart from bla OXA genes with MBLs, genes such as bla IMP-14a have been reported in CRAP isolates from Thailand, while bla NDM -carrying organisms have been reported in countries like Malaysia, Taiwan, South Korea, Japan, and Brazil, but not in Thailand [ 4 , 6 , 8 , 9 , 10 , 11 ]. Genomic characterization of metallo-β-lactamase harboring A. pittii has not yet been investigated in the isolates from Thailand.…”

Section: Introductionmentioning

confidence: 99%

Genomic Characterization of Clinical Extensively Drug-Resistant Acinetobacter pittii Isolates

et al. 2021

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Carbapenem-resistant Acinetobacter pittii (CRAP) is a causative agent of nosocomial infections. This study aimed to characterize clinical isolates of CRAP from a tertiary hospital in Northeast Thailand. Six isolates were confirmed as extensively drug-resistant Acinetobacter pittii (XDRAP). The blaNDM-1 gene was detected in three isolates, whereas blaIMP-14 and blaIMP-1 were detected in the others. Multilocus sequence typing with the Pasteur scheme revealed ST220 in two isolates, ST744 in two isolates, and ST63 and ST396 for the remaining two isolates, respectively. Genomic characterization revealed that six XDRAP genes contained antimicrobial resistance genes: ST63 (A436) and ST396 (A1) contained 10 antimicrobial resistance genes, ST220 (A984 and A864) and ST744 (A56 and A273) contained 9 and 8 antimicrobial resistance genes, respectively. The single nucleotide polymorphism (SNP) phylogenetic tree revealed that the isolates A984 and A864 were closely related to A. pittii YB-45 (ST220) from China, while A436 was related to A. pittii WCHAP100020, also from China. A273 and A56 isolates (ST744) were clustered together; these isolates were closely related to strains 2014S07-126, AP43, and WCHAP005069, which were isolated from Taiwan and China. Strict implementation of infection control based upon the framework of epidemiological analyses is essential to prevent outbreaks and contain the spread of the pathogen. Continued surveillance and close monitoring with molecular epidemiological tools are needed.

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“…Carbapenem resistance in A. pittii is mainly associated with the production of the carbapenem-hydrolyzing class D β-lactamases (CHDLs), such as OXA-23, OXA-58, OXA-72, OXA-143, and their variants (Zander et al, 2014a;D'Souza et al, 2017;Singkham-In and Chatsuwan, 2018;Chen et al, 2019). Besides, NDM-1-producing A. pittii isolates have also been reported in several cases (Yang et al, 2012;Hammerum et al, 2015;Pailhories et al, 2017;Deglmann et al, 2019). The emergence of carbapenem resistance in A. pittii reflects its ability to acquire and spread resistance genes, posing a challenge to the management of carbapenemresistant non-baumannii Acinetobacter spp.…”

Section: Introductionmentioning

confidence: 99%

Phenotypic Variation and Carbapenem Resistance Potential in OXA-499-Producing Acinetobacter pittii

Zhang

Han

et al. 2020

Front. Microbiol.

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Acinetobacter pittii is increasingly recognized as a clinically important species. Here, we identified a carbapenem-non-resistant A. pittii clinical isolate, A1254, harboring bla OXA−499 , bla OXA−826 , and bla ADC−221. The bla OXA−499 genetic environment in A1254 was identical to that of another OXA-499-producing, but carbapenem-resistant, A. pittii isolate, YMC2010/8/T346, indicating the existence of phenotypic variation among OXA-499-producing A. pittii strains. Under imipenem-selective pressure, the A1254 isolate developed resistance to carbapenems in 60 generations. Two carbapenem-resistant mutants (CAB009 and CAB010) with mutations in the bla OXA−499 promoter region were isolated from two independently evolved populations (CAB001 and CAB004). The CAB009 mutant, with a mutation at position −14 (A to G), exhibited a four-fold higher carbapenem minimum inhibitory concentration (MIC) and a 4.53 ± 0.19 log 2 fold change higher expression level of bla OXA−499 than the ancestor strain, A1254. The other mutant, CAB010, with a mutation at position −42 (G to A), showed a twofold higher carbapenem MIC and a 1.65 ± 0.25 log 2 fold change higher bla OXA−499 expression level than the ancestor strain. The bla OXA−499 gene and its promoter region were amplified from the wild-type strain and two mutant isolates and then individually cloned into the pYMAb2-Hyg r vector and expressed in Acinetobacter baumannii ATCC 17978, A. pittii LMG 1035, and A. pittii A1254. All the transformed strains were resistant to carbapenem, irrespective of whether they harbored the initial or an evolved promoter sequence, and transformed strains expressing the promoter from the most resistant mutant, CAB009, showed the highest carbapenem MICs, with values of 32-64 µg/ml for imipenem and 128 µg/ml for meropenem. RNA sequencing was performed to confirm the contribution of bla OXA−499 to the development of carbapenem resistance. Although the CAB009 and CAB010 transcriptional patterns were different, bla OXA−499 was the only differentially expressed gene shared by the two mutants.

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Earliest identification of New Delhi metallo-β-lactamase 1 (NDM-1) in Acinetobacter pittii in Brazil

Cited by 7 publications

References 10 publications

The Experience of Implementing a National Antimicrobial Resistance Surveillance System in Brazil

The Experience of Implementing a National Antimicrobial Resistance Surveillance System in Brazil

Genomic Characterization of Clinical Extensively Drug-Resistant Acinetobacter pittii Isolates

Phenotypic Variation and Carbapenem Resistance Potential in OXA-499-Producing Acinetobacter pittii

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