Characterization of 16S rRNA methylase genes in Enterobacterales and Pseudomonas aeruginosa in Athens Metropolitan area, 2015–2016

Nafplioti, Konstantina; Souli, María; Adamou, Panagiota; Moraitou, Eleni; Giannopoulou, Panagiota; Chra, Paraskevi; Damala, Maria; Vogiatzakis, Evangelos; Trikka-Graphakos, Eleftheria; Baka, Vasiliki; Prifti, Eleni; Antoniadou, Anastasia; Galani, Irene

doi:10.1007/s10096-020-04006-3

Cited by 5 publications

(3 citation statements)

References 32 publications

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“…Such a frequent association between carbapenemase-producing and RMTase-producing Enterobacterales was already reported in different parts of the world [5][6][7][8][9][10][11][12][13]21,[27][28][29][30][31][32][33][34][35][36][37]. The origin of those isolates being identified in Switzerland could be autochthonous theoretically; nevertheless, clinical information (only partially obtained and therefore not presented in that study) showed that many of them corresponded to imported cases, and particularly from Eastern European countries, from Italy, and from the Indian subcontinent.…”

Section: Discussionmentioning

confidence: 72%

“…It was shown during the last decade that the occurrence of RMTases was particularly frequent among NDM-producing Enterobacterales , which was either due to the acquisition of distinct plasmids encoding a carbapenemase and an RMTases by given isolates, or (though to a lower extent) to the acquisition of plasmids carrying both RMTase and NDM encoding genes [ 5 ]. Recent reports from different geographical areas showed that the co-production of RMTases and carbapenemases was on the rise in Enterobacterales , such as in Spain with RmtF dominating over other RMTases and mainly being identified in Klebsiella pneumoniae and Enterobacter cloacae bearing the bla OXA-48 , bla NDM-1 , and bla VIM-1 carbapenemase genes, or in Greece with RmtB and KPC being the dominating RMTase and carbapenemase enzymes, respectively [ 6 , 7 ]. Similarly, a study performed in China showed a high prevalence of RMTases among carbapenem-resistant K. pneumoniae clinical isolates associated with bloodstream infections in eleven hospitals [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Increasing Trends of Association of 16S rRNA Methylases and Carbapenemases in Enterobacterales Clinical Isolates from Switzerland, 2017–2020

et al. 2022

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Aminoglycosides (AGs) in combination with β-lactams play an important role in antimicrobial therapy in severe infections. Pan-resistance to clinically relevant AGs increasingly arises from the production of 16S rRNA methylases (RMTases) that are mostly encoded by plasmids in Gram-negative bacteria. The recent emergence and spread of isolates encoding RMTases is worrisome, considering that they often co-produce extended-spectrum β-lactamases (ESBLs) or carbapenemases. Our study aimed to retrospectively analyze and characterize the association of carbapenem- and aminoglycoside-resistant clinical isolates in Switzerland during a 3.5-year period between January 2017 and June 2020. A total of 103 pan-aminoglycoside- and carbapenem-resistant clinical isolates were recovered at the NARA (Swiss National Reference Center for Emerging Antibiotic Resistance) during the 2017–2020 period. Carbapenemase and RMTase determinants were identified by PCR and sequencing. The characterization of plasmids bearing resistance determinants was performed by a mating-out assay followed by PCR-based replicon typing (PBRT). Clonality of the isolates was investigated by multilocus sequence typing (MLST). Over the 991 Enterobacterales collected at the NARA during this period, 103 (10.4%) of them were resistant to both carbapenems and all aminoglycosides. Among these 103 isolates, 35 isolates produced NDM-like carbapenemases, followed by OXA-48-like (n = 23), KPC-like (n = 21), or no carbapenemase (n = 13), OXA-48-like and NDM-like co-production (n = 7), and VIM-like enzymes (n = 4). The RMTases ArmA, RmtB, RmtC, RmtF, RmtG, and RmtB + RmtF were identified among 51.4%, 13.6%, 4.9%, 24.3%, 1%, and 1%, respectively. Plasmid co-localization of the carbapenemase and the RMTase encoding genes was found among ca. 20% of the isolates. A high diversity was identified in terms of the nature of associations between RMTase and carbapenemase-encoding genes, of incompatibility groups of the corresponding plasmids, and of strain genetic backgrounds, highlighting heterogeneous importations rather than clonal dissemination.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Increasing Trends of Association of 16S rRNA Methylases and Carbapenemases in Enterobacterales Clinical Isolates from Switzerland, 2017–2020

et al. 2022

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“…Recent reports from the carbapenemase endemic countries, such as China and Greece demonstrate an increase in the prevalence of RMTs amongst CPK isolates [7,8]. There is a dart of epidemiological studies looking at the aminoglycoside resistance rates and resistance mechanisms for invasive CPK isolates, particularly in OXA-48 endemic settings.…”

Section: Introductionmentioning

confidence: 99%

High prevalence of ArmA-16S rRNA methyltransferase among aminoglycoside-resistant Klebsiella pneumoniae bloodstream isolates

Isler

Falconer

Vatansever

et al. 2022

Journal of Medical Microbiology

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Introduction. Aminoglycosides are used for the treatment of carbapenemase-producing Klebsiella pneumoniae (CPK) infections. 16S rRNA methyltransferases (RMTs) confer resistance to all aminoglycosides and are often cocarried with NDM. Hypothesis/Gap Statement. There is a dart of studies looking at the aminoglycoside resistance mechanisms for invasive CPK isolates, particularly in OXA-48 endemic settings. Aim. We aimed to determine the prevalence of RMTs and their association with beta lactamases and MLSTs amongst aminoglycoside-resistant CPK bloodstream isolates in an OXA-48 endemic setting. Methodology. CPK isolates (n=181), collected as part of a multicentre cohort study, were tested for amikacin, gentamicin and tobramycin susceptibility using custom-made sensititre plates (GN2XF, Thermo Fisher Scientific). All isolates were previously subjected to whole-genome sequencing. Carbapenemases, RMTs, MLSTs and plasmid incompatibility groups were detected on the assembled genomes. Results. Of the 181 isolates, 109(60 %) were resistant to all three aminoglycosides, and 96 of 109(88 %) aminoglycoside-resistant isolates carried an RMT (85 ArmA, 10 RmtC, 4 RmtF1; three isolates cocarried ArmA and RmtC). Main clonal types associated with ArmA were ST2096 (49/85, 58 %) and ST14 (24/85, 28 %), harbouring mainly OXA-232 and OXA-48 +NDM, respectively. RmtC was cocarried with NDM (5/10) on ST395, and NDM +OXA-48 or NDM +KPC (4/10) on ST14, ST15 and ST16. All RMT producers also carried CTX-M-15, and the majority cocarried SHV-106, TEM-150 and multiple other antibiotic resistance genes. The majority of the isolates harboured a combination of IncFIB, IncH and IncL/M type plasmids. Non-NDM producing isolates remained susceptible to ceftazidime-avibactam. Conclusion. Aminoglycoside resistance amongst CPK bloodstream isolates is extremely common and mainly driven by clonal spread of ArmA carried on ST2096 and ST14, associated with OXA-232 and OXA48 +NDM carriage, respectively.

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Multidrug-resistant Klebsiella pneumoniae: mechanisms of resistance including updated data for novel β-lactam-β-lactamase inhibitor combinations

Galani

Karaiskos

Giamarellou

2021

Expert Review of Anti-infective Therapy

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Characterization of 16S rRNA methylase genes in Enterobacterales and Pseudomonas aeruginosa in Athens Metropolitan area, 2015–2016

Cited by 5 publications

References 32 publications

Increasing Trends of Association of 16S rRNA Methylases and Carbapenemases in Enterobacterales Clinical Isolates from Switzerland, 2017–2020

Increasing Trends of Association of 16S rRNA Methylases and Carbapenemases in Enterobacterales Clinical Isolates from Switzerland, 2017–2020

High prevalence of ArmA-16S rRNA methyltransferase among aminoglycoside-resistant Klebsiella pneumoniae bloodstream isolates

Multidrug-resistant Klebsiella pneumoniae: mechanisms of resistance including updated data for novel β-lactam-β-lactamase inhibitor combinations

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