Dissemination of carbapenemase‐producing Enterobacteriaceae and associated resistance determinants through global food systems

Abstract

Antimicrobial agents are a critical component of modern healthcare systems, fulfilling a core function in patient care and improving individual patient outcomes and consequently overall public health. However, the efficacy of antimicrobial interventions is being consistently eroded by the emergence and dissemination of various antimicrobial resistance (AMR) mechanisms. One highly valued class of antimicrobial compounds is carbapenems, which retain efficacy in treating most multidrug‐resistant infections and are considered “last line” agents. Therefore, recent trends in proliferation of carbapenem resistance (CR) via dissemination of carbapenemase‐encoding genes among members of the Enterobacteriaceae family pose a significant threat to public health. While much of the focus relating to this has been on nosocomial environments, community‐acquired carbapenemase‐producing Enterobacteriaceae (CPE) infections and their associated transmission routes are less well studied. Among these community‐associated vectors, the role of food chains and contaminated foods is important, since Enterobacteriaceae occupy niches within these settings. This review examines foodborne CPE transmission by exploring how interactions within and between food, the food chain, and agriculture not only promote and disseminate CPE, but also create reservoirs of mobile genetic elements that may lead to further carbapenemase gene proliferation both within and between microbial communities. Additionally, recent developments regarding the global occurrence and molecular epidemiology of CPEs in food chains will be reviewed.

Chromosomal integration and plasmid fusion occurring in ST20 carbapenem-resistant Klebsiella pneumoniae isolates coharboring bla NDM-1 and bla IMP-4 induce resistance transmission and fitness variation

“…The carbapenem resistance gene bla IMP is typically carried by plasmids but is occasionally reported to be carried on the chromosome [ 28 ]; for instance, Abe et al reported that bla IMP-6 was located on the chromosome in E. coli [ 29 ], and Miyazato et al reported that bla IMP-60 was located on the chromosome in Enterobacter asburiae [ 30 ]. In this study, we found a chromosomally integrated bla IMP-4 gene in K. pneumoniae .…”