Draft genome sequence of KPC-2-producing Pseudomonas aeruginosa recovered from a bloodstream infection sample in Brazil

Santos, Ivson Cassiano de Oliveira; Albano, Rodolpho Mattos; Asensi, Marise Dutra; Carvalho-Assef, Ana Paula D’Alincourt

doi:10.1016/j.jgar.2018.08.021

Cited by 20 publications

(10 citation statements)

References 6 publications

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“…Over the last 5-year period, IncQ1 plasmids carrying bla KPC-2 have been reported in several different pathogens in Brazil including Klebsiella quasipneumoniae (1 isolate, BSI), K. pneumoniae ST340 (CC258) (1 isolate, no clinical data), and Pseudomonas aeruginosa ST2584 (1 isolate, BSI), as shown in Fig. 3 ( 29 – 31 ). This current outbreak added a further six additional cases and suggests that IncQ1 plasmids can act as efficient bla KPC-2 carriers.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Molecular Description of a High-Copy IncQ1 KPC-2 Plasmid Harbored by the International ST15 Klebsiella pneumoniae Clone

Martins

Nicolás

et al. 2020

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This study provides the genomic characterization and clinical description of bloodstream infections (BSI) cases due to ST15 KPC-2 producer Klebsiella pneumoniae. Six KPC-K. pneumoniae isolates were recovered in 2015 in a tertiary Brazilian hospital and were analyzed by whole-genome sequencing (WGS) (Illumina MiSeq short reads). Of these, two isolates were further analyzed by Nanopore MinION sequencing, allowing complete chromosome and plasmid circularization (hybrid assembly), using Unicycler software. The clinical analysis showed that the 30-day overall mortality for these BSI cases was high (83%). The isolates exhibited meropenem resistance (MICs, 32 to 128 mg/liter), with 3/6 isolates resistant to polymyxin B. The conjugative properties of the blaKPC-2 plasmid and its copy number were assessed by standard conjugation experiments and sequence copy number analysis. We identified in all six isolates a small (8.3-kb), high-copy-number (20 copies/cell) non-self-conjugative IncQ plasmid harboring blaKPC-2 in a non-Tn4401 transposon. This plasmid backbone was previously reported to harbor blaKPC-2 only in Brazil, and it could be comobilized at a high frequency (10−4) into Escherichia coli J53 and into several high-risk K. pneumoniae clones (ST258, ST15, and ST101) by a common IncL/M helper plasmid, suggesting the potential of international spread. This study thus identified the international K. pneumoniae ST15 clone as a carrier of blaKPC-2 in a high-copy-number IncQ1 plasmid that is easily transmissible among other common Klebsiella strains. This finding is of concern since IncQ1 plasmids are efficient antimicrobial resistance determinant carriers across Gram-negative species. The spread of such carbapenemase-encoding IncQ1 plasmids should therefore be closely monitored. IMPORTANCE In many parts of the world, carbapenem resistance is a serious public health concern. In Brazil, carbapenem resistance in Enterobacterales is mostly driven by the dissemination of KPC-2-producing K. pneumoniae clones. Despite being endemic in this country, only a few reports providing both clinical and genomic data are available in Brazil, which limit the understanding of the real clinical impact caused by the dissemination of different clones carrying blaKPC-2 in Brazilian hospitals. Although several of these KPC-2-producer K. pneumoniae isolates belong to the clonal complex 258 and carry Tn4401 transposons located on large plasmids, a concomitant emergence and silent dissemination of small high-copy-number blaKPC-2 plasmids are of importance, as described in this study. Our data identify a small high-copy-number IncQ1 KPC plasmid, its clinical relevance, and the potential for conjugative transfer into several K. pneumoniae isolates, belonging to different international lineages, such as ST258, ST101, and ST15.

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Section: Discussionmentioning

confidence: 99%

Clinical and Molecular Description of a High-Copy IncQ1 KPC-2 Plasmid Harbored by the International ST15 Klebsiella pneumoniae Clone

Martins

Nicolás

et al. 2020

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“…Likewise, the chromosomal bla GES-20 carbapenemase gene was identified in a study of hospital isolates of P. aeruginosa from Mexico [68]. Apart from GES family, and, although KPC is commonly detected in Enterobacteriaceae, reports of KPC-2 in P. aeruginosa are accumulating, including data from Germany [230], Brazil [231], China [232], and Puerto Rico [233]. The bla KPC gene is carried by plasmids, which suggests the possibility of an inter-genus spread from Enterobacteriaceae into non-fermenters, even though evidence of such a spread is still unclear [224].…”

Section: Pseudomonasmentioning

confidence: 99%

The Current Burden of Carbapenemases: Review of Significant Properties and Dissemination among Gram-Negative Bacteria

2020

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Carbapenemases are β-lactamases belonging to different Ambler classes (A, B, D) and can be encoded by both chromosomal and plasmid-mediated genes. These enzymes represent the most potent β-lactamases, which hydrolyze a broad variety of β-lactams, including carbapenems, cephalosporins, penicillin, and aztreonam. The major issues associated with carbapenemase production are clinical due to compromising the activity of the last resort antibiotics used for treating serious infections, and epidemiological due to their dissemination into various bacteria across almost all geographic regions. Carbapenemase-producing Enterobacteriaceae have received more attention upon their first report in the early 1990s. Currently, there is increased awareness of the impact of nonfermenting bacteria, such as Acinetobacter baumannii and Pseudomonas aeruginosa, as well as other Gram-negative bacteria that are carbapenemase-producers. Outside the scope of clinical importance, carbapenemases are also detected in bacteria from environmental and zoonotic niches, which raises greater concerns over their prevalence, and the need for public health measures to control consequences of their propagation. The aims of the current review are to define and categorize the different families of carbapenemases, and to overview the main lines of their spread across different bacterial groups.

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“…Interestingly, large direct repeats could flank genomic rearrangements between NTE KPC elements and small mobilizable plasmids. In fact, recent studies have reported the presence of these small plasmids in KPC-2-producing Pseudomonas aeruginosa and Escherichia coli and in BKC-positive Klebsiella pneumoniae isolates (12)(13)(14)(15).…”

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confidence: 99%

Small IncQ1 and Col-Like Plasmids Harboring bla _KPC-2 and Non-Tn 4401 Elements (NTE _KPC -IId) in High-Risk Lineages of Klebsiella pneumoniae CG258

Cerdeira

Lam

Wyres

et al. 2019

Antimicrob Agents Chemother

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Draft genome sequence of KPC-2-producing Pseudomonas aeruginosa recovered from a bloodstream infection sample in Brazil

Cited by 20 publications

References 6 publications

Clinical and Molecular Description of a High-Copy IncQ1 KPC-2 Plasmid Harbored by the International ST15 Klebsiella pneumoniae Clone

Clinical and Molecular Description of a High-Copy IncQ1 KPC-2 Plasmid Harbored by the International ST15 Klebsiella pneumoniae Clone

The Current Burden of Carbapenemases: Review of Significant Properties and Dissemination among Gram-Negative Bacteria

Small IncQ1 and Col-Like Plasmids Harboring bla _KPC-2 and Non-Tn 4401 Elements (NTE _KPC -IId) in High-Risk Lineages of Klebsiella pneumoniae CG258

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Draft genome sequence of KPC-2-producing Pseudomonas aeruginosa recovered from a bloodstream infection sample in Brazil

Cited by 20 publications

References 6 publications

Clinical and Molecular Description of a High-Copy IncQ1 KPC-2 Plasmid Harbored by the International ST15 Klebsiella pneumoniae Clone

Clinical and Molecular Description of a High-Copy IncQ1 KPC-2 Plasmid Harbored by the International ST15 Klebsiella pneumoniae Clone

The Current Burden of Carbapenemases: Review of Significant Properties and Dissemination among Gram-Negative Bacteria

Small IncQ1 and Col-Like Plasmids Harboring bla KPC-2 and Non-Tn 4401 Elements (NTE KPC -IId) in High-Risk Lineages of Klebsiella pneumoniae CG258

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Small IncQ1 and Col-Like Plasmids Harboring bla _KPC-2 and Non-Tn 4401 Elements (NTE _KPC -IId) in High-Risk Lineages of Klebsiella pneumoniae CG258