First clonal spread of KPC-producing Pseudomonas aeruginosa in Buenos Aires, Argentina

Santella, Gisela; Cittadini, R.; Papalia, Mariana Andrea; Ocampo, Cecilia Vera; Castillo, Marcelo Del; Vay, Carlos; Gutkind, Gabriel; Radice, Marcela

doi:10.1016/j.meegid.2012.03.022

Cited by 11 publications

(7 citation statements)

References 26 publications

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“…Although KPC-2 harboring P. aeruginosa has also been detected in Trinidad and Tobago, the United States, Puerto Rico, Brazil, Argentina, and China, the global spread of epidemic strains has been difficult to assess due to MLST not having been used in the majority of countries (8)(9)(10)(11)(12). Contrary to the situation in Colombia, where the emergence of KPC-2 producing isolates has been linked to several clones, mainly of ST235 but also of ST308, ST1006, and ST1060, in Argentina it seems that the spread of KPC-2 in five provinces occurred through the dissemination of one successful clone, ST654 (8,27). In addition, high genetic diversity according to PFGE and MLST was found in bla VIM and noncarbapenemase-producing isolates.…”

Section: Discussionmentioning

confidence: 99%

Similar Frequencies of Pseudomonas aeruginosa Isolates Producing KPC and VIM Carbapenemases in Diverse Genetic Clones at Tertiary-Care Hospitals in Medellín, Colombia

et al. 2014

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g Carbapenem-resistant Pseudomonas aeruginosa has become a serious health threat worldwide due to the limited options available for its treatment. Understanding its epidemiology contributes to the control of antibiotic resistance. The aim of this study was to describe the clinical and molecular characteristics of infections caused by carbapenem-resistant P. aeruginosa isolates in five tertiary-care hospitals in Medellín, Colombia. A cross-sectional study was conducted in five tertiary-care hospitals from June 2012 to March 2014. All hospitalized patients infected by carbapenem-resistant P. aeruginosa were included. Clinical information was obtained from medical records. Molecular analyses included PCR for detection of bla VIM , bla IMP , bla NDM , bla OXA-48 , and bla KPC genes plus pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) for molecular typing. A total of 235 patients were enrolled: 91.1% of them were adults (n ‫؍‬ 214), 88.1% (n ‫؍‬ 207) had prior antibiotic use, and 14.9% (n ‫؍‬ 35) had urinary tract infections. The bla VIM-2 and bla KPC-2 genes were detected in 13.6% (n ‫؍‬ 32) and 11.5% (n ‫؍‬ 27), respectively, of all isolates. Two isolates harbored both genes simultaneously. For KPC-producing isolates, PFGE revealed closely related strains within each hospital, and sequence types (STs) ST362 and ST235 and two new STs were found by MLST. With PFGE, VIM-producing isolates appeared highly diverse, and MLST revealed ST111 in four hospitals and five new STs. These results show that KPC-producing P. aeruginosa is currently disseminating rapidly and occurring at a frequency similar to that of VIM-producing P. aeruginosa isolates (approximately 1:1 ratio) in Medellín, Colombia. Diverse genetic backgrounds among resistant strains suggest an excessive antibiotic pressure resulting in the selection of resistant strains.

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Section: Discussionmentioning

confidence: 99%

Similar Frequencies of Pseudomonas aeruginosa Isolates Producing KPC and VIM Carbapenemases in Diverse Genetic Clones at Tertiary-Care Hospitals in Medellín, Colombia

et al. 2014

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“…KPC in P. aeruginosa is rare and occurs mainly in the American continent [ 1 - 5 , 12 ]. Recently, P. aeruginosa harbouring KPC was described in Argentina [ 13 ] and Iran [ 14 ], showing the potential rapid dissemination of this mechanism of resistance to the world.…”

Section: Discussionmentioning

confidence: 99%

“…Our data showed different clones circulating in our hospital and a new one predominate clone harboring KPC. A recent study also described dissemination of a new clone of P. aeruginosa harbouring KPC in a hospital in Argentina after a K. pneumonia- KPC positive outbreak [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Characterization of carbapenem-resistant Pseudomonas aeruginosa clinical isolates, carrying multiple genes coding for this antibiotic resistance

Rizek

Santos

et al. 2014

Ann Clin Microbiol Antimicrob

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BackgroundCarbapenemase genes are one of the most frequent mechanisms reported in carbapenem-resistant P. aeruginosa; however, description of P. aeruginosa co-harbouring two or more carbapenemases is unusual.MethodsIn this study we evaluated the presence of carbapenemase genes and the clonality of P. aeruginosa isolates obtained from a hospital over a 12-year period. A total of 127 isolates of carbapenem-resistant P. aeruginosa recovered from 109 patients feces (four samples), rectal swab (three samples), nasal swab (one sample) and anal abscess (one sample), were evaluated. Minimum inhibitory concentrations of the following antibiotics imipenem, meropenem and polymyxin E were determined by broth microdilution. The molecular profile of isolates was evaluated by pulsed field gel electrophoresis (PFGE). PCR for the following carbapenemase genes blaIMP;blaSPM;blaVIM;blaSIM;blaNDM;blaKPC;blaGES and nucleotide sequencing to confirm the enzyme gene types were performed and compared with the database available on the Internet (BLAST-http://www.ncbi.nlm.nhi.gov/blast/).ResultsAll isolates were carbapenem-resistant, their MIC50 and MIC90 were respectively 64 μg/mL and 256 μg/mL to imipenem and 32 μg/mL and 256 μg/mL to meropenem, all isolates except one (MIC = 8 mg/L) were susceptible to polymyxin E. The most frequent carbapenemase genes identified were blaSPM identified in 41 isolates (32%), followed by 10 with blakpc and 5 with blaVIM (3.9%). All belonged to the class SPM-1 and VIM-2. In 2011, one isolate harbouring three carbapenemase genes (SPM-1, VIM-2 and KPC-2) that belonged to a new clone was identified in a hematopoietic stem cell transplanted patient. Then, 19 carbapenem-resistant P. aeruginosa were identified in an outbreak that occurred in the bone marrow transplant unit, all positive for SPM-1 gene, and 9 (47.3%) harbored both SPM-1 and KPC.ConclusionOur findings showed that PCR for KPC gene should be performed to evaluate carbapenem resistance in P. aeruginosa and that this agent can harbor more than one carbapenemase gene. Attention should be focused on the possible rapid spread of KPC in P. aeruginosa isolates and for the fact that P. aeruginosa may become a reservoir of this transmissible resistance mechanism.

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“…The genes encoding IMP and VIM are located on integrons, which also carry other antibiotics resistance genes favoring their worldwide dissemination (Hong et al, 2015;van der Zee et al, 2018). P. aeruginosa carrying class A carbapenemases such as Klebsiella pneumoniae carbapenemases (KPC) have become increasingly important due to their continuous dissemination worldwide including Asia and America during the last decade (Santella et al, 2012;Carrara-Marroni et al, 2015;Hu et al, 2015;Potron et al, 2015). Its dissemination is facilitated by genes encoded on transposable elements and plasmids (Naas et al, 2013;Dai et al, 2016;Hu et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Genetic Diversity of Multidrug-Resistant Pseudomonas aeruginosa Isolates Carrying blaVIM–2 and blaKPC–2 Genes That Spread on Different Genetic Environment in Colombia

et al. 2021

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Pseudomonas aeruginosa is an opportunistic Gram-negative pathogen with an increase in the frequency of infections caused by multidrug resistant (MDR) and extensively drug resistant (XDR) strains, limiting the available therapeutic options. The most troublesome resistance is the acquisition and production of carbapenemases such as Verona integron-encoded metallo-β-lactamases (VIM), the most frequent and widespread, and the Klebsiella pneumoniae carbapenemases (KPC), which has continuously spread in the last decade. Its dissemination is linked to their location on mobile genetic elements (MGEs). In Colombia, VIM and KPC have been increasing in its frequency showing major successful dissemination. In this article, we molecularly characterized and analyzed the genetic context of blaVIM and blaKPC in carbapenem-resistant P. aeruginosa (CRPA) isolates from infected and colonized patients in two tertiary-care hospitals, one in Medellín and the other in a municipality close to Medellín, both areas with high carbapenemase endemicity in Colombia (2013–2015). Using whole-genome sequencing (WGS), we identified a remarkable variety of genetic backgrounds in these MDR P. aeruginosa isolates carrying blaKPC–2 and blaVIM–2. There were a diversity of class 1 integron and variations in the gene cassettes associated to blaVIM–2, as well as a possible event of spread of blaKPC–2 mediated by a plasmid that contained part of Tn4401b in one infection case. The dissemination of blaVIM–2 and blaKPC–2 in P. aeruginosa in this area in Colombia has been strongly influenced by successful international clones, carrying these genes and additional determinants of resistance on MGEs, accompanied by gene rearrangement under an antimicrobial selection pressure. These findings emphasize the need to implement control strategies based on rational antibiotic use.

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First clonal spread of KPC-producing Pseudomonas aeruginosa in Buenos Aires, Argentina

Cited by 11 publications

References 26 publications

Similar Frequencies of Pseudomonas aeruginosa Isolates Producing KPC and VIM Carbapenemases in Diverse Genetic Clones at Tertiary-Care Hospitals in Medellín, Colombia

Similar Frequencies of Pseudomonas aeruginosa Isolates Producing KPC and VIM Carbapenemases in Diverse Genetic Clones at Tertiary-Care Hospitals in Medellín, Colombia

Characterization of carbapenem-resistant Pseudomonas aeruginosa clinical isolates, carrying multiple genes coding for this antibiotic resistance

Genetic Diversity of Multidrug-Resistant Pseudomonas aeruginosa Isolates Carrying blaVIM–2 and blaKPC–2 Genes That Spread on Different Genetic Environment in Colombia

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