Emergence of carbapenem-resistant Escherichia coli producing CMY-2-type AmpC β-lactamase in Brazil

Pavez, Mónica; Neves, Patrícia; Dropa, Milena; Matté, Maria Helena; Grinbaum, Renato Satovschi; Araújo, Maria; Mamizuka, Elsa Masae; Lincopán, Nilton

doi:10.1099/jmm.0.2008/002774-0

Cited by 29 publications

(24 citation statements)

References 13 publications

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“…The results are worrisome considering the probable acquisition of resistance to other antimicrobials, such as carbapenems by E. coli. The emergence of carbapenem-resistant E. coli producing CMY-2-type AmpC b-lactamase in Brazil has been recently described, 34 highlighting the need of surveillance initiatives for E. coli strains in clinical microbiology laboratories.…”

Section: Resultsmentioning

confidence: 99%

First Description ofbla_CTX-M-14- andbla_CTX-M-15-ProducingEscherichia coliIsolates in Brazil

Cergole-Novella

Guth²,

Castanheira³

et al. 2010

Microbial Drug Resistance

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We evaluated the antimicrobial resistance patterns and molecular characteristics of 11 extraintestinal Escherichia coli strains and 1 intestinal E. coli from human infections collected in Brazil. Two E. coli strains were nonsusceptible to extended spectrum cephalosporins (cefotaxime, ceftazidime, and cefepime); one isolated from diarrhea carried bla(CTX-M-14) and bla(TEM-1), whereas the other, isolated from tracheal secretion, carried bla(CTX-M-15) and bla(OXA-1). Five E. coli strains showed resistance to quinolones. Integrase associated with class 1 integron (intl1) was detected in 8 of the 12 E. coli strains belonging to various serotypes and this gene was carried by plasmids showing similar size. Pulsed-field gel electrophoresis showed that E. coli strains were genetically diverse, and phylogenetic grouping showed that the E. coli strains belonged to groups A, B2, and D (33.3%), respectively. This is the first report of E. coli isolates carrying bla(CTX-M-14) and bla(CTX-M-15) in Brazil. The presence of mobile elements containing antimicrobial resistance genes is worrisome since it could promote the dissemination of resistance and lead to the acquisition of resistance to other antimicrobials agents such as the carbapenems.

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Section: Resultsmentioning

confidence: 99%

First Description ofbla_CTX-M-14- andbla_CTX-M-15-ProducingEscherichia coliIsolates in Brazil

Cergole-Novella

Guth²,

Castanheira³

et al. 2010

Microbial Drug Resistance

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“…Both enzymes were detected in E. coli 42, 43. The FOX-5-like encoding gene was detected during the DNA sequencing of a 41-kb conjugative plasmid that harbored a qnrA gene and a class 1 integron with the aadB and catB3 gene cassettes 43 .…”

Section: Plasmid-mediated Ampcsmentioning

confidence: 99%

“…The FOX-5-like encoding gene was detected during the DNA sequencing of a 41-kb conjugative plasmid that harbored a qnrA gene and a class 1 integron with the aadB and catB3 gene cassettes 43 . The CMY-2-like enzyme was detected in four carbapenem-resistant E. coli strains, which also possessed alteration in the outer membrane proteins, isolated from a single patient 42 . Dias and colleagues studied the prevalence of pAmpC among Enterobacteriacea e isolated from a teaching hospital in Rio de Janeiro.…”

Section: Plasmid-mediated Ampcsmentioning

confidence: 99%

Antimicrobial resistance in Enterobacteriaceae in Brazil: focus on β-lactams and polymyxins

Sampaio

Gales

2016

Brazilian Journal of Microbiology

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During the last 30 years there has been a dissemination of plasmid-mediated β-lactamases in Enterobacteriaceae in Brazil. Extended spectrum β-lactamases (ESBL) are widely disseminated in the hospital setting and are detected in a lower frequency in the community setting. Cefotaximases are the most frequently detected ESBL type and Klebsiella pneumoniae is the predominant species among ESBL producers. Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae became widely disseminated in Brazil during the last decade and KPC production is currently the most frequent resistance mechanism (96.2%) in carbapenem resistant K. pneumoniae. To date KPC-2 is the only variant reported in Brazil. Polymyxin B resistance in KPC-2-producing K. pneumoniae has come to an alarming rate of 27.1% in 2015 in São Paulo, the largest city in Brazil. New Delhi metallo-β-lactamase was detected in Brazil in 2013, has been reported in different Brazilian states but are not widely disseminated. Antimicrobial resistance in Enterobacteriaceae in Brazil is a very serious problem that needs urgent actions which includes both more strict adherence to infection control measures and more judicious use of antimicrobials.

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“…The presence of ACC is very worrying as they are not inhibited by clavulanic acid and reports about its detection have been raising in the last decade, in clinical isolates of all over the world (Girlich et al, 2000; Nadjar et al, 2000; Makanera et al, 2003; Bidet et al, 2005; Miró et al, 2005; Ohana et al, 2005). In Brazil, the presence of isolates carrying plasmid-mediated AmpC has been sporadically reported and is still scarce (Castanheira et al, 2007; Pavez et al, 2008; Campana et al, 2013). However, in hospital sewage of Rio de Janeiro, they were one of the most abundant Class C types (5–8% of Class C reads).…”

Section: Discussionmentioning

confidence: 99%

Distribution and Classification of Serine β-Lactamases in Brazilian Hospital Sewage and Other Environmental Metagenomes Deposited in Public Databases

et al. 2016

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β-lactam is the most used antibiotic class in the clinical area and it acts on blocking the bacteria cell wall synthesis, causing cell death. However, some bacteria have evolved resistance to these antibiotics mainly due the production of enzymes known as β-lactamases. Hospital sewage is an important source of dispersion of multidrug-resistant bacteria in rivers and oceans. In this work, we used next-generation DNA sequencing to explore the diversity and dissemination of serine β-lactamases in two hospital sewage from Rio de Janeiro, Brazil (South Zone, SZ and North Zone, NZ), presenting different profiles, and to compare them with public environmental data available. Also, we propose a Hidden-Markov-Model approach to screen potential serine β-lactamases genes (in public environments samples and generated hospital sewage data), exploring its evolutionary relationships. Due to the high variability in β-lactamases, we used a position-specific scoring matrix search method (RPS-BLAST) against conserved domain database profiles (CDD, Pfam, and COG) followed by visual inspection to detect conserved motifs, to increase the reliability of the results and remove possible false positives. We were able to identify novel β-lactamases from Brazilian hospital sewage and to estimate relative abundance of its types. The highest relative abundance found in SZ was the Class A (50%), while Class D is predominant in NZ (55%). CfxA (65%) and ACC (47%) types were the most abundant genes detected in SZ, while in NZ the most frequent were OXA-10 (32%), CfxA (28%), ACC (21%), CEPA (20%), and FOX (19%). Phylogenetic analysis revealed β-lactamases from Brazilian hospital sewage grouped in the same clade and close to sequences belonging to Firmicutes and Bacteroidetes groups, but distant from potential β-lactamases screened from public environmental data, that grouped closer to β-lactamases of Proteobacteria. Our results demonstrated that HMM-based approach identified homologs of serine β-lactamases, indicating the specificity and high sensitivity of this approach in large datasets, contributing for the identification and classification of a large number of homologous genes, comprising possible new ones. Phylogenetic analysis revealed the potential reservoir of β-lactam resistance genes in the environment, contributing to understanding the evolution and dissemination of these genes.

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Emergence of carbapenem-resistant Escherichia coli producing CMY-2-type AmpC β-lactamase in Brazil

Cited by 29 publications

References 13 publications

First Description ofbla_CTX-M-14- andbla_CTX-M-15-ProducingEscherichia coliIsolates in Brazil

First Description ofbla_CTX-M-14- andbla_CTX-M-15-ProducingEscherichia coliIsolates in Brazil

Antimicrobial resistance in Enterobacteriaceae in Brazil: focus on β-lactams and polymyxins

Distribution and Classification of Serine β-Lactamases in Brazilian Hospital Sewage and Other Environmental Metagenomes Deposited in Public Databases

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Emergence of carbapenem-resistant Escherichia coli producing CMY-2-type AmpC β-lactamase in Brazil

Cited by 29 publications

References 13 publications

First Description ofblaCTX-M-14- andblaCTX-M-15-ProducingEscherichia coliIsolates in Brazil

First Description ofblaCTX-M-14- andblaCTX-M-15-ProducingEscherichia coliIsolates in Brazil

Antimicrobial resistance in Enterobacteriaceae in Brazil: focus on β-lactams and polymyxins

Distribution and Classification of Serine β-Lactamases in Brazilian Hospital Sewage and Other Environmental Metagenomes Deposited in Public Databases

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Product

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First Description ofbla_CTX-M-14- andbla_CTX-M-15-ProducingEscherichia coliIsolates in Brazil

First Description ofbla_CTX-M-14- andbla_CTX-M-15-ProducingEscherichia coliIsolates in Brazil