Extraintestinal Pathogenic <i>Escherichia coli</i> ST405 Isolate Coharboring blaNDM-5 and blaCTXM-15: A New Threat in Mozambique

Sumbana, José João; Santona, Antonella; Fiamma, Maura; Taviani, Elisa; Deligios, Massimo; Zimba, Tomás F.; Lucas, Gilberto; Sacarlal, Jahit; Rubino, Salvatore; Paglietti, Bianca

doi:10.1089/mdr.2020.0334

Cited by 12 publications

(12 citation statements)

References 32 publications

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“…Since then, bla NDM-5 in humans has been reported in Egypt [ 37 ], Angola [ 38 ], South Africa [ 39 ], Nigeria [ 40 ], Chad [ 15 ] and Malawi [ 41, 42 ]. Recently, bla NDM-5 producing E. coli have been detected in Mali from one outpatient [ 21 ] and in Mozambique in a patient with a bloodstream infection [ 12 ]. The reason for increased detection of bla NDM-5 -producing Gram-negative bacteria in Africa is not known, it could be independent introduction from the rest of the world.…”

Section: Discussionmentioning

confidence: 99%

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First identification of bla NDM-5 producing Escherichia coli from neonates and a HIV infected adult in Tanzania

Manyahi

Moyo

Kibwana

et al. 2022

Journal of Medical Microbiology

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Introduction. Carbapenem-resistant members of the family Enterobacteriaceae are emerging as a global public-health threat and cause substantial challenges in clinical practice. Gap Statement. There is a need for increased and continued genomic surveillance of antimicrobial resistance genes globally in order to detect outbreaks and dissemination of clinically important resistance genes and their associated mobile genetic elements in human pathogens. Aim. To describe the resistance mechanisms of carbapenem-resistant Escherichia coli . Methods. Rectal swabs from neonates and newly diagnosed human immunodeficiency virus (HIV) infected adults were collected between April 2017 and May 2018 and screened for faecal carriage of carbapenamases and OXA-48 producing members of the family Enterobacteriaceae. Bacterial isolates were identified using matrix assisted laser desorption ionization time of flight mass spectrometry. Antimicrobial susceptibility testing was performed by E-test. Whole genomes of carbapenem-resistant E. coli were investigated using a hybrid assembly of Illumina and Oxford Nanopore Technologies sequencing reads. Results. Three carbapenem-resistant E. coli were detected, two from neonates and one from an HIV infected adult. All three isolates carried bla NDM-5. Two E. coli from neonates belonged to ST167 and bla NDM-5 co-existed with bla CTX-M-15 and bla OXA-01, and all were carried on IncFIA type plasmids. The E. coli from the HIV infected adult belonged to ST2083, and carried bla NDM-5 on an IncX3 type plasmid and bla CMY-42 on an IncI type plasmid. All bla NDM-5 carrying plasmids contained conjugation related genes. In addition, E. coli from the HIV infected adult carried three more plasmid types; IncFIA, IncFIB and Col(BS512). One E. coli from a neonate also carried one extra plasmid Col(BS512). All three E. coli harboured resistance genes to fluoroquinolone, aminoglycosides, sulfamethoxazole, trimethoprim, macrolides and tetracycline, carried on the IncFIA type plasmid. Furthermore, E. coli from the neonates carried a chloramphenicol resistance gene (catB3), also on the IncFIA plasmid. All three isolates were susceptible to colistin. Conclusion. This is the first report, to our knowledge, from Tanzania detecting bla NDM-5 producing E. coli. The carbapenemase gene was carried on an IncFIA and IncX3 type plasmids. Our findings highlight the urgent need for a robust antimicrobial resistance (AMR) surveillance system to monitor and rapidly report on the incidence and spread of emerging resistant bacteria in Tanzania.

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Section: Discussionmentioning

confidence: 99%

“…The bla NDM-5 is mostly carried on plasmids, which also may carry resistance genes to other antibiotics [ 12, 13 ] and catalyse their transfer between bacteria. Several plasmids have been reported to carry bla NDM-5 [ 5 ], with IncX3 type plasmid being the most commonly reported [ 4, 14, 15 ].…”

Section: Introductionmentioning

confidence: 99%

First identification of bla NDM-5 producing Escherichia coli from neonates and a HIV infected adult in Tanzania

Manyahi

Moyo

Kibwana

et al. 2022

Journal of Medical Microbiology

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“…CTX-M-15 has been reported in Mozambique, particularly in Klebsiella pneumoniae and E. coli isolates, associated with invasive and non-invasive infections (Pons et al 2015;Guiral et al 2018). In addition, recent studies carried out at MCH reported the dominance of CTX-M-15 and AmpC-genes in E. coli isolated from urine and blood cultures (Estaleva et al 2021) and the occurrence of a pandemic E. coli ST405 clone coharboring bla NDM-5 and bla CTX-M-15 (Sumbana et al 2021).…”

Section: Discussionmentioning

confidence: 99%

“…In the same hospital, Klebsiella spp. and E. coli isolates, carrying the bla CTX-M-15 were isolated since 2015 (Estaleva et al 2021;Sumbana et al 2021), which may have contributed to the spread of the resistance. These finding reinforce the idea that at MCH, penicillins and beta-lactam antibiotics are not suitable for the treatment of infections caused by Enterobacteriaceae.…”

Section: Discussionmentioning

confidence: 99%

Polyclonal emergence of MDR Enterobacter cloacae complex isolates producing multiple extended spectrum beta-lactamases at Maputo Central Hospital, Mozambique

Sumbana

Santona

Fiamma

et al. 2022

Rend. Fis. Acc. Lincei

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Enterobacter spp. are important nosocomial pathogens responsible of a wide variety of infections, mainly due to Extended Spectrum β-Lactamase (ESBL) producing isolates, constituting a global public health issue in terms of clinical treatment and infection control, especially in low-income countries, where last-line treatment is often unavailable and there is weak nosocomial surveillance. In this study, we conducted a phenotypic and molecular characterization of 8 clinical Enterobacter spp. strains, isolated from patient’s blood in three hospitals in Mozambique. Isolates were identified by MALDI-TOF and antimicrobial Susceptibility Testing was performed by VITEK 2 system. Half of isolates were analyzed by PCR for β-lactamases genes, other isolates by Whole Genome Sequencing. We identified all isolates as Enterobacter cloacae complex (ECC), those from Maputo Central Hospital were polyclonal, multidrug resistant (5/8), and ESBL producers (50%), carrying blaCTX-M-15 and different assortment of blaSHV-12, blaTEM-1B and blaOXA-1, and AmpCs blaCMH-3, blaACT-7 and blaACT-9 genes. Resistance determinants linked to fluoroquinolone (aac(6')Ib-cr and qnrB1) and others antimicrobials were also found. Notably, one isolate showed phenotypically resistance to colistin, while another colistin susceptible isolate carried a silent mcr-9 gene. ECC nosocomial surveillance is urgently needed to contain and prevent the dissemination of ESBLs producing clones, and mcr-9 spread to other Enterobacteriaceae.

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“…The isolated strain carried bla NDM-5 , and among others bla CMY-42 , aadA2, mdf(A), sul1 and alterations of gyrA, parC, parE [121]. The presence of bla NDM-5 has also been detected in Japan and Mozambique, Africa [63,64]. This clone in Japan was non-susceptible to fluoroquinolones and β-lactams, including broad-spectrum cephalosporins and carbapenems, but it kept its susceptibility against tigecycline.…”

Section: St405 and High-risk Cc/st38 Clones From Phylogenetic Group Dmentioning

confidence: 99%

Emergence and Dissemination of Extraintestinal Pathogenic High-Risk International Clones of Escherichia coli

Kocsis

Gulyás

Szabó

2022

Life

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Multiresistant Escherichia coli has been disseminated worldwide, and it is one of the major causative agents of nosocomial infections. E. coli has a remarkable and complex genomic plasticity for taking up and accumulating genetic elements; thus, multiresistant high-risk clones can evolve. In this review, we summarise all available data about internationally disseminated extraintestinal pathogenic high-risk E. coli clones based on whole-genome sequence (WGS) data and confirmed outbreaks. Based on genetic markers, E. coli is clustered into eight phylogenetic groups. Nowadays, the E. coli ST131 clone from phylogenetic group B2 is the predominant high-risk clone worldwide. Currently, strains of the C1-M27 subclade within clade C of ST131 are circulating and becoming prominent in Canada, China, Germany, Hungary and Japan. The C1-M27 subclade is characterised by blaCTX-M-27. Recently, the ST1193 clone has been reported as an emerging high-risk clone from phylogenetic group B2. ST38 clone carrying blaOXA-244 (a blaOXA-48-like carbapenemase gene) caused several outbreaks in Germany and Switzerland. Further high-risk international E. coli clones include ST10, ST69, ST73, ST405, ST410, ST457. High-risk E. coli strains are present in different niches, in the human intestinal tract and in animals, and persist in environment. These strains can be transmitted easily within the community as well as in hospital settings. WGS analysis is a useful tool for tracking the dissemination of resistance determinants, the emergence of high-risk mulitresistant E. coli clones and to analyse changes in the E. coli population on a genomic level.

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Extraintestinal Pathogenic Escherichia coli ST405 Isolate Coharboring blaNDM-5 and blaCTXM-15: A New Threat in Mozambique

Cited by 12 publications

References 32 publications

First identification of bla NDM-5 producing Escherichia coli from neonates and a HIV infected adult in Tanzania

First identification of bla NDM-5 producing Escherichia coli from neonates and a HIV infected adult in Tanzania

Polyclonal emergence of MDR Enterobacter cloacae complex isolates producing multiple extended spectrum beta-lactamases at Maputo Central Hospital, Mozambique

Emergence and Dissemination of Extraintestinal Pathogenic High-Risk International Clones of Escherichia coli

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