Dynamics and molecular features of OXA-48-like-producing Klebsiella pneumoniae lineages in a Tunisian hospital

Messaoudi, Aziza; Haenni, Marisa; Bouallègue, Olfa; Saras, Estelle; Châtre, Pierre; Chaouch, Cherifa; Boujaafar, N.; Mansour, Wejdène; Madec, Jean‐Yves

doi:10.1016/j.jgar.2019.07.005

Cited by 14 publications

(11 citation statements)

References 59 publications

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“…The coexistence of carbapenemase and ESBL was found in 18 isolates. The high incidence (67%) of isolates with coexpression of carbapenemase and ESBL found in this study has also been noted in previous studies from Tunisia and other parts of the world (Uz Zaman et al 2014;Loucif et al 2016;Yu et al 2019;Messaoudi et al 2020;Sharahi et al 2021).…”

Section: Phenotypic and Genotypic Profiles Of Carbapenemresistant Iso...supporting

confidence: 89%

“…In the present study, isolates belonging to ST101 harboured the carbapenemase OXA-48. OXA-48-producing K. pneumoniae ST101 isolates were initially identified in Tunisia in 2012 (Lahlaoui et al 2012), and are considered to be a major driver of the carbapenem-resistant-Enterobacterales epidemic in this country (Ben Helal et al 2018;Ben Tanfous et al 2018a, 2018bMessaoudi, et al 2020). This finding, along with previous reports of individual cases or outbreaks of ST101 OXA-48 K. pneumoniae in Algeria (Loucif et al 2016), Spain (Pitart et al 2011;Cubero et al 2015), Switzerland (Seiffert et al 2014), Turkey (Can et al 2018), Bulgaria (Markovska et al 2015), Serbia (Palmieri et al 2020) and Germany (Kaase et al 2016), suggests intercontinental dissemination and emphasizes the key role of Kp-ST101 clone in the worldwide dissemination of OXA-48.…”

Section: Molecular Characterization Of Oxa-48 Carbapenemaseproducing ...mentioning

confidence: 99%

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Co-occurrence of genes encoding carbapenemase, ESBL, pAmpC and non-β-Lactam resistance among Klebsiella pneumonia and E. coli clinical isolates in Tunisia

Sallem

Laribi

Arfaoui

et al. 2022

Letters in Applied Microbiology

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This study aimed to investigate the molecular mechanisms of carbapenem and colistin resistance in K. pneumoniae and E. coli isolates obtained from hospitalized patients in Carthagene International Hospital of Tunis. A total of 25 K. pneumoniae and 2 E. coli clinical isolates with reduced susceptibility to carbapenems were recovered. Susceptibility testing and phenotypic screening tests were carried out. ESBL, AmpC, carbapenemase and other antibiotic resistance genes were sought by PCR‐sequencing. The presence of plasmid‐mediated colistin resistance genes (mcr‐1‐8) was examined by PCR and the nucleotide sequence of the mgrB gene was determined. The analysis of plasmid content was performed by PCR‐Based Replicon Typing (PBRT). The clonality of isolates was assessed by PFGE and multilocus sequence typing (MLST). All of the isolates produced carbapenemase activity. They showed a great variation in the distribution of ESBL, AmpC, carbapenemase and other plasmid‐mediated resistance determinants. K. pneumoniae isolates carried blaNDM‐1 (n = 11), blaOXA‐48 (n = 11), blaNDM‐1 + blaOXA‐48 (n = 1), blaNDM‐1 + blaVIM‐1 (n = 1), blaOXA‐204 (n = 1), along with blaCTX‐M, blaOXA, blaTEM, blaCMY, blaDHA and blaSHV genes variants on conjugative plasmid of IncL/M, IncR, IncFIIK, IncFIB, and IncHI1 types. Three sequence types ST101, ST307 and ST15 were identified. The mgrB alteration g109a (G37S) was detected in a single colistin‐resistant, NDM‐1 and OXA‐48‐coproducing K. pneumoniae isolate. The two E. coli isolates belonged to ST95, co‐produced NDM‐1 and CTX‐M‐15, and harboured plasmid of IncFII and IncFIB types. To our knowledge, this is the first report in Tunisia of NDM‐1, OXA‐48, and CTX‐M‐15 coexistence in colistin‐resistant K. pneumoniae ST15.

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Section: Phenotypic and Genotypic Profiles Of Carbapenemresistant Iso...supporting

confidence: 89%

Section: Molecular Characterization Of Oxa-48 Carbapenemaseproducing ...mentioning

confidence: 99%

Co-occurrence of genes encoding carbapenemase, ESBL, pAmpC and non-β-Lactam resistance among Klebsiella pneumonia and E. coli clinical isolates in Tunisia

Sallem

Laribi

Arfaoui

et al. 2022

Letters in Applied Microbiology

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“…In this investigation, only 12 and 3 CRKP strains harbored bla NDM and bla OXA-48-like genes respectively. Indeed, the bla OXA-48-like producers were more prevalent in western countries such as France, Spain and Germany, but were rare in China [30][31][32]. In addition, the bla genes screened were absent in five CRKP isolates.…”

Section: Discussionmentioning

confidence: 99%

Clinical and microbiological characteristics of nosocomial, healthcare-associated, and community-acquired Klebsiella pneumoniae infections in Guangzhou, China

Wang

Zeng

et al. 2021

Antimicrob Resist Infect Control

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Background Klebsiella pneumoniae (K. pneumoniae) is a common pathogen associated with hospital and community-onset infections. This study aimed to compare the clinical and microbiological characteristics of nosocomial, healthcare-associated (HCA), and community-acquired (CA) K. pneumoniae infections. Methods Clinical data were extracted from electronic medical records and analyzed retrospectively. Antimicrobial susceptibility and extended-spectrum beta-lactamase (ESBL) production were determined for all identified strains. Carbapenemase and ESBL genes were amplified by PCR. Genotyping of carbapenem-resistant K. pneumoniae (CRKP) and ESBL-producing strains was performed by pulsed-field gel electrophoresis (PFGE). Results Of 379 K. pneumoniae infections, 98 (25.9%) were nosocomial, 195 (51.5%) were healthcare-associated, and 86 (22.6%) were community-acquired. Hematological malignancy (OR = 4.467), and hypertension (OR = 2.08) and cerebral vascular disease (OR = 2.486) were associated with nosocomial and HCA infections respectively, when compared to CA infections. Overall, the incidence of antimicrobial resistance for the majority of agents tested was similar between nosocomial and HCA infections (P > 0.05) and both groups had a higher incidence than CA infections (P < 0.05). Moreover, 95.1% (78/82) of CRKP strains were isolated from the nosocomial and HCA groups. The blaKPC was the most prevalent carbapenemase gene among CRKP strains (80.5%, 66/82). ESBL-producing strains were prevalent among nosocomial (40.8%), HCA (35.9%) and CA groups (24.4%). The blaCTX-M-9-group and blaCTX-M-1-group genes were predominant in nosocomial (65.0%) and CA strains (66.7%), respectively. PFGE results showed ESBL-producing and CRKP strains were genetically diverse. Identical PFGE profiles were observed among HCA and nosocomial strains. Conclusions Nosocomial and HCA K. pneumoniae infections presented similar clinical features and antimicrobial resistance, and both two types of infections were different to CA infections. CRKP and ESBL-producing strains were disseminated mainly in HCA and nosocomial groups, and showed a clonal diversity. The cross transmission of CRKP was existed among HCA and nosocomial patients. This finding suggests that similar empirical therapy should be considered for patients with nosocomial and HCA K. pneumoniae infections and bacterial resistance surveillance of these infections is necessary.

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“…OXA-48 producing K. pneumoniae had been previously reported in different countries including Lebanon [20,34], whereas K. pneumoniae isolates harboring the bla OXA-48 and the bla NDM-6 gene simultaneously, have never been reported worldwide. OXA-48 producing K. pneumoniae (ST11, ST14, ST17, ST101, and ST3367) have been reported in different countries worldwide, such as Taiwan and Greece [39,40], Spain [41], Algeria and Tunisia [42,43] and Italy [44]. Furthermore, three OXA-48 producing K. pneumoniae have ST13.…”

Section: Discussionmentioning

confidence: 99%

“…Results also showed that the two OXA-48 and NDM-6 coproducing K. pneumoniae isolates having the sequence type ST147 were collected from two patients during their hospitalization without carrying this bacterium at the time of admission. This sequence type ST147 has been associated with different nosocomial outbreaks in different countries such as China [47] and Tunisia [42]. A strategy must be implemented to prevent the spread of these resistant microorganisms among patients.…”

Section: Discussionmentioning

confidence: 99%

Carbapenem and colistin-resistant bacteria in North Lebanon: Coexistence of mcr-1 and NDM-4 genes in Escherichia coli

Al-Bayssari

Dagher

Hamoui

et al. 2021

J Infect Dev Ctries

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Introduction: The increasing incidence of infections caused by multidrug-resistant bacteria is considered a global health problem. This study aimed to investigate this resistance in Gram-negative bacteria isolated from patients hospitalized in North-Lebanon. Methodology: All isolates were identified using the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic susceptibility testing was achieved using disk diffusion, E-test and Broth microdilution methods. Phenotypic detection of carbapenemase was carried out using the CarbaNP test. RT-PCR, standard-PCR and sequencing were performed to detect resistance genes and oprD gene. Conjugal transfer was carried out between our isolates and Escherichia coli J53 to detect the genetic localization of resistance genes. MLST was conducted to determine the genotype of each isolate. Results: Twenty-three carbapenem-resistant Enterobacterales of which eight colistin-resistant Escherichia coli, and Twenty carbapenem-resistant Pseudomonas aeruginosa were isolated. All isolates showed an imipenem MIC greater than 32 mg/mL with MICs for colistin greater than 2 mg/L for E. coli isolates. All the Enterobacterales isolates had at least one carbapenemase-encoding gene, with E. coli isolates coharboring blaNDM-4 and mcr-1 genes. Moreover, 16/20 Pseudomonas aeruginosa harbored the blaVIM-2 gene and 18/20 had mutations in the oprD gene. MLST revealed that the isolates belonged to several clones. Conclusions: We report here the first description in the world of clinical E. coli isolates coharboring blaNDM-4 and mcr-1 genes, and K. pneumoniae isolates producing NDM-6 and OXA-48 carbapenemases. Also, we describe the emergence of NDM-1-producing E. cloacae in Lebanon. Screening for these isolates is necessary to limit the spread of resistant microorganisms in hospitals.

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Dynamics and molecular features of OXA-48-like-producing Klebsiella pneumoniae lineages in a Tunisian hospital

Cited by 14 publications

References 59 publications

Co-occurrence of genes encoding carbapenemase, ESBL, pAmpC and non-β-Lactam resistance among Klebsiella pneumonia and E. coli clinical isolates in Tunisia

Co-occurrence of genes encoding carbapenemase, ESBL, pAmpC and non-β-Lactam resistance among Klebsiella pneumonia and E. coli clinical isolates in Tunisia

Clinical and microbiological characteristics of nosocomial, healthcare-associated, and community-acquired Klebsiella pneumoniae infections in Guangzhou, China

Carbapenem and colistin-resistant bacteria in North Lebanon: Coexistence of mcr-1 and NDM-4 genes in Escherichia coli

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