KPC-3–Producing<i>Serratia marcescens</i>Outbreak between Acute and Long-Term Care Facilities, Florida, USA

Jiménez, Adriana; Abbo, Lilian M.; Martínez, Octavio; Shukla, Bhavarth; Sposato, Kathleen; Iovleva, Alina; Fowler, Erin L.; McElheny, Christi L.; Doi, Yasufumi

doi:10.3201/eid2611.202203

Cited by 8 publications

(6 citation statements)

References 11 publications

(11 reference statements)

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“…In this context, plasmids containing ESBLs were first identified in Germany in 1983 in K. pneumoniae and S. marcescens, and were transferable to other Enterobacteriaceae 2 . A few epidemic ESBL clones (TEM or SHV mutants) were described in hospitals in France and Belgium in the late 1980's and mid-1990's [14][15][16][17][18][19] and rapidly spread throughout Europe and globally 2,3,9,14,[20][21][22][23][24][25][26][27] . In the late 1990's, ESBLs were almost exclusively TEM or SHV variants, predominantly in K. pneumoniae 14 .…”

Section: Mechanisms Of Antimicrobial Resistance (Amr)mentioning

confidence: 99%

“…Subsequently, ESBLs not closely related to TEM or SHV (e.g., CTX-M types) arose [24][25][26] . Clonal dissemination was noted within and between hospitals 15 and long-term care facilities (LTCFs) 19 , associated with endemic and epidemic outbreaks. Although some ESBL-producing Enterobacteriaceae confer CP resistance 9 , CPs remain the preferred therapy for most strains of ESBL-producing Enterobacteriaceae 2,28 .…”

Section: Mechanisms Of Antimicrobial Resistance (Amr)mentioning

confidence: 99%

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Escalating antimicrobial resistance among Enterobacteriaceae: focus on carbapenemases

Lynch¹,

Clark

Zhanel

2021

Expert Opinion on Pharmacotherapy

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aminoglycosides (AG); antimicrobial resistance (AMR); -lactamase inhibitors (BLI); blood stream infections (BSIs) ; carbapenem (CP); carbapenemase (CPase); carbapenem-resistant (CR); carbapenemresistant Enterobacterales (CRE) ;-lactam inhibitor (BLI); CP-resistant K. pneumoniae (CRKP); CPsusceptible K. pneumoniae (CSKP); ceftazidime/avibactam (CAZ-AVI); cephalosporins (CEPHS); central line-associated (CLA); central venous catheter (CVC); community-acquired infection (CAI); complicated intra-abdominal infection (c-IAI); complicated urinary tract infection (c-UTI); defined daily dose (DDD) ; extended-spectrum -lactamases (ESBLs); extensively Drug Resistant (eXDR); fluoroquinolones (FQ); Gram negative bacteria (GNB); gross domestic product per capita (GDPPC); high-income countries (HICs); hospital acquired infection (HAI); imipenem-relebactam (IMI-REL); intensive care units (ICUs); Klebsiella pneumoniae carbapenemases (KPCs); long-term care facilities (LTCFs); low-and middleincome countries (LMICs); mechanical ventilation; metallo-lactamase (MBL); minimal inhibitory concentration (MIC); mobile genetic elements (MGEs); multidrug resistant (MDR); New Delhi Metalloproteinase-1 (NDM-1); non-Proteus Enterobacterales (NPE); organ transplant recipients (OTR); piperacillin/tazobactam (PTZ); solid organ transplant (SOT); tigecycline (TGC); ventilator-associated pneumonia (VAP)

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Section: Mechanisms Of Antimicrobial Resistance (Amr)mentioning

confidence: 99%

Section: Mechanisms Of Antimicrobial Resistance (Amr)mentioning

confidence: 99%

Escalating antimicrobial resistance among Enterobacteriaceae: focus on carbapenemases

Lynch¹,

Clark

Zhanel

2021

Expert Opinion on Pharmacotherapy

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“…KPC was also the most common carbapenemase identified in two CRSM studies from Brazil 25 and the USA. 26 Notably, in Madrid, bla VIM-1 and bla OXA-48 predominated, 27 and bla NDM caused an CRSM outbreak in Romania. 28 …”

Section: Discussionmentioning

confidence: 99%

The genomic characterization of carbapenem-resistant Serratia marcescens at a tertiary hospital in South Africa

Overmeyer,

Prentice,

Brink

et al. 2023

JAC-Antimicrobial Resistance

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Background Serratia marcescens is an opportunistic nosocomial pathogen, and recent reports have highlighted the rapid increase in multidrug resistance in this organism. There is a paucity in genomic data for carbapenem-resistant S. marcescens (CRSM). Methods A retrospective cohort study describing laboratory-confirmed CRSM from a tertiary academic hospital in Cape Town, South Africa, for the period 2015–20, was performed. Stored CRSM and contemporary isolates were submitted for WGS using Illumina MiSeq, with the Nextera DNA Flex Library Preparation Kit. Sequence data were analysed in-house using srst2 and Tychus, and CRSM and contemporary isolates were compared. Results Twenty-one CRSM and four contemporary isolates were sequenced and analysed. Twenty-four different resistance genes were identified, with all isolates having at least two resistance genes, and seventeen isolates harbouring three or more genes. This correlated well with phenotypic results. The blaOXA-48-like carbapenemase was the most common carbapenemase identified, in 86% (18/21) of CRSM. A core SNP difference tree indicated that the CRSM could be grouped into three clusters. Eleven isolates had shared plasmids. Several genes and SNPs were identified in the CRSM, which may putatively augment virulence, but this requires further functional characterization. Conclusions A diverse resistome was observed in CRSM, which was also reflected phenotypically, with blaOXA-48-like the most commonly carbapenemase. Though distinct clusters were observed, no clonality was noted, and a limited number of isolates shared plasmids. This study provides genomic data for emerging CRSM and highlights the importance of ongoing genomic surveillance to inform infection prevention control and antimicrobial stewardship initiatives.

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“…In hospital-acquired infections, the prevalence rate of carbapenem-resistant S. marcescens has increased recently ( Prado et al., 2022 ). The production of carbapenemase is the primary cause for the rapid and widespread proliferation of S. marcescens drug resistance ( Firmo et al., 2020 ; Jimenez et al., 2020 ). Despite its clinical relevance and the increasing concerns about AMR, little is known about the epidemiology and genetic diversity of carbapenem-resistant S. marcescens within healthcare institutions.…”

Section: Introductionmentioning

confidence: 99%

Genomic characterization of two carbapenem-resistant Serratia marcescens isolates causing bacteremia: Emergence of KPC-2-encoding IncR plasmids

Jia

Huang²,

Zhang³

et al. 2023

Front. Cell. Infect. Microbiol.

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The occurrence and transmission of carbapenemase-producing-Enterobacterales (CPE) on a global scale has become a major issue. Clinical reports are rarely providing information on the genomic and plasmid features of carbapenem-resistant Serratia marcescens. Our objective was to investigate the resistance and transmission dynamics of two carbapenem-resistant S. marcescens that are resistant to carbapenem and have caused bacteremia in China. Blood specimens were taken from two individuals with bacteremia. Multiplex PCR was employed to identify genes that code for carbapenemase. Antimicrobial susceptibility tests and plasmid analysis were conducted on S. marcescens isolates SM768 and SM4145. The genome of SM768 and SM4145 were completely sequenced using NovaSeq 6000-PE150 and PacBio RS II platforms. Antimicrobial resistance genes (ARGs) were predicted using the ResFinder tool. S1 nuclease pulsed-field gel electrophoresis (S1-PFGE) and southern blotting were employed to analyze plasmids. Two S. marcescens that produced KPC-2 were identified from bloodstream infections. The antimicrobial susceptibility testing demonstrated that both of the isolates had a resistance to various antibiotics. The whole-genome sequence (WGS) and plasmid analysis revealed the presence of blaKPC-2-bearing IncR plasmids and multiple plasmid-borne antimicrobial resistance genes in the isolates. Our comparative plasmid analysis suggested that the two IncR plasmids identified in this study could be derived from a common ancestor. Our findings revealed the emergence of blaKPC-2-bearing IncR plasmid in China, which could be a hindrance to the transmission of KPC-2-producing S. marcescens in clinical settings.

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KPC-3–ProducingSerratia marcescensOutbreak between Acute and Long-Term Care Facilities, Florida, USA

Cited by 8 publications

References 11 publications

Escalating antimicrobial resistance among Enterobacteriaceae: focus on carbapenemases

Escalating antimicrobial resistance among Enterobacteriaceae: focus on carbapenemases

The genomic characterization of carbapenem-resistant Serratia marcescens at a tertiary hospital in South Africa

Genomic characterization of two carbapenem-resistant Serratia marcescens isolates causing bacteremia: Emergence of KPC-2-encoding IncR plasmids

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