Emergence of a Novel Lineage and Wide Spread of a blaCTX-M-15/IncHI2/ST1 Plasmid among Nosocomial Enterobacter in Guadeloupe

Abstract

Between April 2018 and August 2019, a total of 135 strains of Enterobacter cloacae complex (ECC) were randomly collected at the University Hospital Center of Guadeloupe to investigate the structure and diversity of the local bacterial population. These nosocomial isolates were initially identified genetically by the hsp60 typing method, which revealed the clinical relevance of E. xiangfangensis (n = 69). Overall, 57/94 of the third cephalosporin-resistant strains were characterized as extended-spectrum-β-lactamase (ESBL) producers, and their whole-genome was sequenced using Illumina technology to determine the clonal relatedness and diffusion of resistance genes. We found limited genetic diversity among sequence types (STs). ST114 (n = 13), ST1503 (n = 9), ST53 (n = 5) and ST113 (n = 4), which belong to three different Enterobacter species, were the most prevalent among the 57 ESBL producers. The blaCTXM-15 gene was the most prevalent ESBL determinant (56/57) and was in most cases associated with IncHI2/ST1 plasmid replicon carriage (36/57). To fully characterize this predominant blaCTXM-15/IncHI2/ST1 plasmid, four isolates from different lineages were also sequenced using Oxford Nanopore sequencing technology to generate long-reads. Hybrid sequence analyses confirmed the circulation of a well-conserved plasmid among ECC members. In addition, the novel ST1503 and its associated species (ECC taxon 4) were analyzed, in view of its high prevalence in nosocomial infections. These genetic observations confirmed the overall incidence of nosocomial ESBL Enterobacteriaceae infections acquired in this hospital during the study period, which was clearly higher in Guadeloupe (1.59/1000 hospitalization days) than in mainland France (0.52/1,000 hospitalization days). This project revealed issues and future challenges for the management and surveillance of nosocomial and multidrug-resistant Enterobacter in the Caribbean.

The fly route of extended-spectrum-β-lactamase-producing Enterobacteriaceae dissemination in a cattle farm: from the ecosystem to the molecular scale

“…We investigated here the main sources of ESBL E. coli originated from animals, insects, water, feeds, and human wastewater. The ESBL-producing E. cloacae Taxon 4 ST598 found in administrative building wastewater was previously found in hospital wastewater in Guadeloupe and also isolated from patients (Pot et al, 2022). These findings highlight the importance of investigating non-animal or non-human reservoirs of antibiotic-resistant bacteria, as they may play a key role in the spread of resistance and may reach humans through various transmission routes.…”

“…The phylogenetic tree was constructed as described above. Genomic identification of Enterobacter strains was performed using the different approaches described in our previous manuscript (Pot et al, 2022). To fully reconstruct and characterize the major plasmids, 14 bla CTX-M-15 ESBL E. coli isolates were sequenced using Oxford Nanopore sequencing long-reads technology on a MinION device.…”

Whole-Genome Analysis of Extensively Drug-Resistant Enterobacter hormaechei Isolated from a Patient with Non-Hodgkin’s Lymphoma

“…They are also often associated with multi-resistance genes such as those of resistance to aminoglycosides, quinolones, sulfonamides, trimethoprim, tetracycline, chloramphenicol, and other β-lactamase genes [ 26 ]. The broad-spectrum resistance profiles to β-lactams observed in Enterobacteriaceae are either due to the production of ESβL or mediated by the overexpression of the chromosomal ampC gene, which codes for cephalosporinase, with plasmids being the main carriers of multiple resistance genes, including ESBL, in clinical isolates, thus becoming important vehicles for horizontal transfer in this genus [ 27 ]. The association of β-lactamase resistance genes, bla CTX-M-15 , bla GES-2 , bla TEM-1A , bla ACT-15 , bla OXA-1 , and bla NDM-1 , with other genes, such as [ aac(3)-IIa, aac(6′)-Ian, ant(2″)-Ia ], [ aac(6′)-Ib-cr , ( qnr B1)], dfrA25 , sul1 and sul2 , catB3 , fosA , in the same isolate, increasingly potentiate the multi-resistance profile to different antibiotics classes such as β-lactams, aminoglycosides, trimethoprim–sulfamethoxazole, tetracyclines, and amphenicol [ 16 , 18 , 20 ].…”

“…In Croatia, an outbreak of E. hormaechei ST133 carrying bla NDM-1 occurred in the intensive care unit (ICU), with two deaths due to severe infection [ 41 ], while in Germany, in the ICU, different subspecies of E. hormaechei were identified arising from infectious processes. In the city of Guadalupe, clones such as ST114 and ST1503 of E. xiangfangensis were the most prevalent isolates in clinical samples [ 27 ].…”

Do Microorganisms in Bathing Water in Guadeloupe (French West Indies) Have Resistance Genes?

“…Data on resistance to antibiotics in Guadeloupe are scarce and recent. The island has faced the emergence of nosocomial infections associated with carbapenemase-producing Enterobacteriaceae since 2014 and also a high incidence of nosocomial infections caused by ESBL-producing Enterobacteriaceae [9][10][11][12]. Environmental investigations have focused on the faecal carriage of ESBL-producing Enterobacteriaceae in domestic animals [13,14], farm animals [15], and wildlife [16,17] and also on the transmission of clinical strains to the environment [8,18].…”