Emergence of Carbapenem-Resistant ST244, ST292, and ST2446 Pseudomonas aeruginosa Clones in Burn Patients in Yunnan Province

Abstract

Introduction The prevalence of carbapenem-resistant Pseudomonas aeruginosa is increasing persistently, particularly in burn ward isolates. Here, we investigate the prevalence of carbapenem-resistant Pseudomonas aeruginosa in a burn ward of a provincial-level hospital at Kunming, Yunnan province, China. Methods A total of 118 P. aeruginosa strains were isolated from 57 hospitalized patients, and their MICs were measured. Carbapenem-resistant isolates were selected for multilocus sequence typing (MLST). Carbapenem-resistance mechanisms were identified by examining carbapenemase genes and OprD protein and Carba-NP testing. Representative isolates were further characterized by de novo sequencing for carbapenemase molecular background. Results Among 118 P. aeruginosa isolates, 54 (54/118,45.8%) were carbapenem-resistant Pseudomonas aeruginosa , and 3 genotypes were found (ST292, ST244, and ST2446). Non-carbapenemase-producing ST292 was the most prevalent ST, followed by ST2446 and ST244. A novel 13-bp oprD deletion was found in the ST292 clone, which formed the truncated outer membrane protein and may cause carbapenem resistance. ST244 and ST2446 harbored blaIMP-45 and blaIMP-87 , respectively. blaIMP-45 is located in a megaplasmid, together with aac(6’)-Ib3, blaOXA-1, catB3, qnrVC6, armA, msr(E), mph(E), aph(3’)-Ia, tetC / tetR, aac(6’)-Ib3, floR, mexC-mexD-oprJ, fosA and lead to extensive drug resistance. ST2446 contains a carbapenem-resistant gene blaIMP-87 on the chromosome and is acquired by a novel gene cassette array ( blaIMP-87-ant(2”)-Ia-blaOXA-10-aac(6’)-Ib3 ) of class 1 integron. Discussion For the first time, ST244, ST292 and ST2446 are reported emerging in burn patients, with distinctive carbapenem-resistance mechanisms, respectively. The obtained results highlight the need to surveillance carbapenem-resistant isolates in burn patients.

Genomic diversity and molecular epidemiology of a multidrug-resistant Pseudomonas aeruginosa DMC30b isolated from a hospitalized burn patient in Bangladesh

“…3). cgMLST analyses revealed that the closest relatives of P. aeruginosa DMC30b genome were one carbapenem-resistant ST244 P. aeruginosa clone in burn patients in Yunnan province, China [17], and another ST244 strain, P. aeruginosa MRSN 17623, clinical isolate carrying the blaVIM-6 gene recovered from human in the USA (https://www.pseudomonas.com/strain/show/2623) which differed by 285 cgMLST loci (Fig. 3).…”

“…The presence of these carbapenemases in high-risk clones and sequence types (STs) on complete genome or plasmid or the chromosome of P. aeruginosa, may be the cause of its successful dissemination in Bangladesh and beyond. Recent molecular and genomic studies reported that most of the infectious and virulent clones of P. aeruginosa belonged to ST235, ST244, ST308, ST1006, and ST1060 [15][16][17].…”

Investigation of blaIMP-1, blaVIM-1, blaOXA-48 and blaNDM-1 carbapenemase encoding genes among MBL-producing Pseudomonas aeruginosa

“…Muddassir et al, 2021;Fang et al, 2022). Additionally, controlling the strains resisting drugs and preventing from dissipation of such infections in health care centers is considered necessary(Eslami et al, 2018;Ghasemian et al, 2018).…”

Genomic diversity and molecular epidemiology of a multidrug resistantPseudomonas aeruginosaDMC30b isolated from hospitalized burn patient in Bangladesh

“…For the first time, ST244 is reported emerging in burn patients which exhibited a higher level of resistance to several antibiotics. The obtained results highlight the need to surveillance MDR-resistant isolates in burn patients [17, 47]. Epidemiological source tracking revealed that the P. aeruginosa DMC30b strain has close evolutionary relationship with many strains of P. aeruginosa originating from a wide arsenal of clinical samples including enteritis, gastroenteritis (diarrheal diseases), urinary tract infections, and both community- and hospital-acquired bacteraemia in humans and animals (e.g., dog).…”