Carbapenemasas en aislamientos de Pseudomonas aeruginosa resistentes a carbapenémicos aisladas en hospitales de Chile

Costa, Jandira S. Tomás da; Lima, Celia A.; Vera-Leiva, Alejandra; Magdalena, Iván San Martin; Bello-Toledo, Helia; Yévenes, Mariana Domínguez; Opazo-Capurro, Andrés; Montecinos, Sergio Mella; Quezada-Aguiluz, Mario; González-Rocha, Gerardo

doi:10.4067/s0716-10182021000100081

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…The 53 studies included in this review were conducted in American, European, and Asian countries. China (14 studies) [ 14 , 15 , 17 , 19 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], Brazil (10 studies) [ 21 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ], and Colombia (9 studies) [ 22 , 26 , 27 , 28 , 29 , 51 , 52 , 53 , 54 ] were the countries with the most reported studies, followed by Puerto Rico (4 studies) [ 55 , 56 , 57 , 58 ], Chile (2 studies) [ 59 , 60 ], Argentina (2 studies) [ 61 , 62 ], Vietnam (1 study) [ 63 ], Trinidad and Tobago (1 study) [ 64 ], Nepal (1 study) [ 65 ], India (1 study) [ 66 ], Germany (1 study) [ 18 ], Spain (1 study) [ 6 ], and the USA (1 study) […”

Section: Resultsmentioning

confidence: 99%

Worldwide Dissemination of blaKPC Gene by Novel Mobilization Platforms in Pseudomonas aeruginosa: A Systematic Review

et al. 2023

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The dissemination of blaKPC-harboring Pseudomonas aeruginosa (KPC-Pa) is considered a serious public health problem. This study provides an overview of the epidemiology of these isolates to try to elucidate novel mobilization platforms that could contribute to their worldwide spread. A systematic review in PubMed and EMBASE was performed to find articles published up to June 2022. In addition, a search algorithm using NCBI databases was developed to identify sequences that contain possible mobilization platforms. After that, the sequences were filtered and pair-aligned to describe the blaKPC genetic environment. We found 691 KPC-Pa isolates belonging to 41 different sequence types and recovered from 14 countries. Although the blaKPC gene is still mobilized by the transposon Tn4401, the non-Tn4401 elements (NTEKPC) were the most frequent. Our analysis allowed us to identify 25 different NTEKPC, mainly belonging to the NTEKPC-I, and a new type (proposed as IVa) was also observed. This is the first systematic review that consolidates information about the behavior of the blaKPC acquisition in P. aeruginosa and the genetic platforms implied in its successful worldwide spread. Our results show high NTEKPC prevalence in P. aeruginosa and an accelerated dynamic of unrelated clones. All information collected in this review was used to build an interactive online map.

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Section: Resultsmentioning

confidence: 99%

Worldwide Dissemination of blaKPC Gene by Novel Mobilization Platforms in Pseudomonas aeruginosa: A Systematic Review

et al. 2023

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“…Giacoboni et al, and Yauri‐Condor et al, in Peru, reported similar results with CAS for Enterobacterales 19,20 . The use of this test has been extended to P. aeruginosa and Acinetobacter baumannii to identify plasmid‐mediated resistance to colistin using CAS with EDTA 21,22 …”

Section: Discussionmentioning

confidence: 76%

“…19,20 The use of this test has been extended to P. aeruginosa and Acinetobacter baumannii to identify plasmid-mediated resistance to colistin using CAS with EDTA. 21,22 Five isolates of K. pneumoniae with MIC 4 μg/ml gave negative results in CA-3 (2.97% mE), which could be explained due a large number of isolates with MIC 4 μg/ml (n = 45) was included, and this type of errors are frequently reported to occurred near the breakpoint. Errors in MIC values of 2 μg/ml were not observed, but only 17 isolates were included.…”

Section: Discussionmentioning

confidence: 99%

Colistin resistance screening by 3 μg/ml colistin agar in Carbapenemase‐producing Enterobacterales

Soria-Segarra

Soria‐Segarra

Andrade‐Soriano³

et al. 2022

Clinical Laboratory Analysis

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Background In low‐ and middle‐income countries, the use of colistin in therapeutic regimens is common, to treat infections produced for Carbapenemase‐producing Enterobacterales (CPE) due to limited access to the recently discovered‐approved antibiotics. Furthermore, the technical limitations to perform colistin susceptibility tests make it difficult to assess the suitability of this treatment for each patient, as well as to monitor the rates of resistance. In the present study, we describe the use of agar dilution using a unique colistin concentration of 3 μg/ml to discriminate isolates with colistin resistance in CPE obtained from clinical samples. Methods Clinical Laboratory Standards Institute (CLSI) colistin broth microdilution method and dilution agar with a colistin concentration of 3 μg/ml were performed in 168 isolates of CPE obtained from clinical samples in Guayaquil, Ecuador. Broth microdilution was considered our gold standard using CLSI breakpoints as reference (≤2 μg/ml intermediate and ≥4 μg/ml resistant). Categorical agreement was defined as obtaining a reading within the same category with both methodologies. Results Isolates obtained from respiratory samples were the most prevalent (26.19%; n = 44). Klebsiella pneumoniae was the predominant specie (94.04%; n = 158). KPC‐like carbapenemase was present in all the isolates, and interestingly, colistin resistance was not mediated by MCR‐1 production. Categorical agreement between both methods resulted in 97.02%. Conclusion We propose the use of dilution agar with a colistin concentration of 3 μg/ml, as a valid method for screening colistin resistance in low‐ and middle‐income countries to monitor resistance and to perform epidemiological studies.

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Acquisition of resistance to ceftazidime-avibactam during infection treatment in Pseudomonas aeruginosa through D179Y mutation in one of two blaKPC-2 gene copies without losing carbapenem resistance

García

Brito

Alcalde-Rico

et al. 2022

Front. Cell. Infect. Microbiol.

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Ceftazidime/Avibactam (CAZ/AVI) is frequently used to treat KPC-producing Pseudomonas aeruginosa (KPC-PA) and Enterobacterales. CAZ/AVI resistance is driven by several mechanisms. In P. aeruginosa this mainly occurs through alteration of AmpC, porins, and/or efflux pump overexpression, whereas in Enterobacterales it frequently occurs through D179Y substitution in the active site of KPC enzyme. This aminoacid change abolishes AVI binding to the KPC active site, hence inhibition is impaired. However, this substitution also decreases KPC-mediated resistance to carbapenems (“see-saw” effect). The goal of this work was to characterize the in vivo acquisition of CAZ/AVI resistance through D179Y substitution in a KPC-PA isolated from a hospitalized patient after CAZ/AVI treatment. Two KPC-PA isolates were obtained. The first isolate, PA-1, was obtained before CAZ/AVI treatment and was susceptible to CAZ/AVI. The second isolate, PA-2, was obtained after CAZ/AVI treatment and exhibited high-level CAZ/AVI resistance. Characterization of isolates PA-1 and PA-2 was performed through short and long-read whole genome sequencing analysis. The hybrid assembly showed that PA-1 and PA-2A had a single plasmid of 54,030 bp, named pPA-1 and pPA-2 respectively. Each plasmid harbored two copies of the blaKPC-containing Tn4401b transposon. However, while pPA-1 carried two copies of blaKPC-2, pPA-2 had one copy of blaKPC-2 and one copy of blaKPC-33, the allele with the D179Y substitution. Interestingly, isolate PA-2 did not exhibit the “see-saw” effect. The blaKPC-33 allele was detected only through hybrid assembly using a long-read-first approach. The present work describes a KPC-PA isolate harboring a plasmid-borne CAZ/AVI resistance mechanism based on two copies of blaKPC-2-Tn4401b and D179Y mutation in one of them, that is not associated with loss of resistance to carbapenems. These findings highlight the usefulness of a fine-tuned combined analysis of short and long-read data to detect similar emerging resistance mechanisms.

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Carbapenemasas en aislamientos de Pseudomonas aeruginosa resistentes a carbapenémicos aisladas en hospitales de Chile

Cited by 4 publications

References 18 publications

Worldwide Dissemination of blaKPC Gene by Novel Mobilization Platforms in Pseudomonas aeruginosa: A Systematic Review

Worldwide Dissemination of blaKPC Gene by Novel Mobilization Platforms in Pseudomonas aeruginosa: A Systematic Review

Colistin resistance screening by 3 μg/ml colistin agar in Carbapenemase‐producing Enterobacterales

Acquisition of resistance to ceftazidime-avibactam during infection treatment in Pseudomonas aeruginosa through D179Y mutation in one of two blaKPC-2 gene copies without losing carbapenem resistance

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