Emergence of aph(3’)-VI and accumulation of aminoglycoside modifying enzyme genes in KPC-2-possessing Enterobacter aerogenes isolates from infections and colonization in patients from Recife-PE, Brazil

Abstract

Introduction: The objective of this study was to characterize genes of aminoglycoside modifying enzymes (AMEs) in colonizing and infecting isolates of E. aerogenes harboring bla KPC from patients at a public hospital in Recife-PE, Brazil. Methods: We analyzed 29 E. aerogenes clinical isolates resistant to aminoglycosides. AMEs genes were investigated by PCR and sequencing. Results: Colonizing and infecting isolates mainly presented the genetic profiles aac(3)-IIa/aph(3')-VI or ant(2")-IIa/aph(3')-VI. This is the first report of aph(3')-VI in E. aerogenes harboring bla KPC in Brazil. Conclusions: The results highlight the importance in establishing rigorous methods for the surveillance of resistance genes, especially in colonized patients.

First report of coexistence of blaKPC-2 and blaNDM-1 in carbapenem-resistant clinical isolates of Klebsiella aerogenes in Brazil

“…Although most of the CRKA strains were susceptible to aminoglycosides (gentamicin and/or amikacin), a high percentage of the isolates were found to contain the aph(3’)-VI gene, a plasmid-encoded aminoglycoside phosphotransferase that confers resistance to amikacin. Studies have shown that Enterobacter aerogenes can carry both aph(3’)-VI and bla KPC ( Firmo et al, 2019 ), and also aph(3’)-VI with bla NDM ( Chen et al, 2015 ). However, to the best of our knowledge, this is the first report of Klebsiella aerogenes concomitant harboring aph(3’)-VI , bla KPC-2 , and bla NDM-1 genes, as can be seen in the CRKA315 strain.…”

Comparative resistome, mobilome, and microbial composition of retail chicken originated from conventional, organic, and antibiotic-free production systems

“…Gene aph (3′)-VI, the second most abundant ARG in the co-resistome, codifies a modifying enzyme that is active against most aminoglycosides, including amikacin. Previously described in A. baumannii ( Martin et al, 1988 ), it has been recently emerged as a key mechanism associated with the accumulation of aminoglycoside modifying enzymes in KPC-2-carrying Enterobacter aerogenes causing infections in Brazil ( Firmo et al, 2019 ).…”

Aplikasi Antimicrobial Susceptibility Test (AST) dalam Mendeteksi Carbapenem-Resistant Enterobacteriaceae (CRE): Sebuah Tinjauan Sistematis

“…5 Sedangkan studi-studi lain yang bertujuan mendeteksi CP-CRE menunjukkan prevalensi CRE yang lebih bervariasi, yakni mulai dari 3,8% hingga 100%. 10,[12][13][14][15][16][17][18][19][20] Mayoritas sampel berasal dari urin (27,2%) dan darah (27,2%). Sebagian kecil sampel berasal dari usap dubur, sekret trakea, ujung kateter, cairan asites, usap luka, tinja, sputum, selang endotrakeal, usap vagina, cairan peritoneal, cairan purulen prapankreas, dan abses perianal.…”

“…10,11,13,14,[16][17][18][19][20] Sementara itu, dua studi lainnya hanya mencantumkan jumlah kasus positif CRE tanpa menyebutkan metode AST yang digunakan dalam mendeteksi CRE. 12,15 Kelima studi tersebut kebanyakan mendeteksi carbapenemase-producing CRE (CP-CRE) dengan metode polymerase chain reaction (PCR) dan carba Nordmann-Poirel (carba NP) (Tabel 1).…”

“…Secara umum, studi lanjutan dapat dilakukan untuk melihat produksi karbapenemase dan/ atau menganalisis gen penghasil karbapenemase. 15 Hal tersebut berkaitan dengan tujuan penelitian tersebut, apakah tentang epidemiologi, perbandingan metode deteksi, deteksi faktor risiko dan kejadian resistensi pada terapi CRE. [12][13][14] Salah satu hal yang mendasari banyaknya ditemukan studi yang berfokus pada CP-CRE adalah luaran klinis yang lebih buruk pada pasien CP-CRE dibandingkan pasien non-CP-CRE.…”