Spread of GES-5 carbapenemase-producing Pseudomonas aeruginosa clinical isolates in Japan due to clonal expansion of ST235

Abstract

The first outbreak in Japan of GES-5 carbapenemase-producing Pseudomonas aeruginosa occurred in a long-term care facility in 2014. To assess the spread of GES-5 producing P. aeruginosa clinical isolates in medical settings in Japan, 1,476 carbapenem-resistant P. aeruginosa isolates obtained from 2012 to 2016 were characterized. Of these 1,476 isolates, 104 (7.0%) harbored blaGES-5. Southern blotting revealed that the blaGES-5 was located on the chromosome. The isolation rates of these GES-5 producers increased significantly every year, from 2.0% (6 of 295) in 2012 to 2.8% (8 of 283) in 2013 to 5.3% (16 of 303) in 2014 to 9.7% (29 of 300) in 2015 to 15.3% (45 of 295) in 2016. Of the 104 GES-5 producers, 102 belonged to clonal complex (CC) 235, including 99 belonging to ST235 and three belonging to ST2233). Whole genome sequence analysis revealed that CC235 P. aeruginosa harboring blaGES-5 spread in a clonal manner. These results indicate that these GES-5 producing CC235 P. aeruginosa clinical isolates have spread in medical settings throughout Japan.

The Current Burden of Carbapenemases: Review of Significant Properties and Dissemination among Gram-Negative Bacteria

“…Recently, GES-5 and GES-24 carbapenemases were isolated from P. aeruginosa from long-term care facilities in South Korea [225]. GES-5 was also detected in studies from Canada [226], Indonesia [227], Dubai [67], and Japan [228]. A variant of GES-5 called GES-18 was isolated from P. aeruginosa recovered from the endotracheal aspirate of an elderly patient hospitalized in Belgium [229].…”

Phenylboronic Acids Probing Molecular Recognition against Class A and Class C β-lactamases

“…GES-type β-lactamases, belonging to class A carbapenemases, have been increasingly reported among Gram-negative pathogens, including P. aeruginosa, Enterobacter cloacae, Klebsiella pneumoniae, and Acinetobacter baumannii. At present, 37 GES-variants have been detected worldwide [12]. AmpC β-lactamases are clinically relevant cephalosporinases.…”

Phenotypic and Genomic Comparison of the Two Most Common ExoU-Positive Pseudomonas aeruginosa Clones, PA14 and ST235

“…Most ST235 strains were collected between 1998 and 2007. They are susceptible to the common antipseudomonal agents in contrast to the ST235 isolates reported from the last decade that were typically either multidrug or extensively drug resistant (21,22,(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49). Thus, our strains may be of interest for the research community to study the unusual features of ST235 in a normal antibiotic-sensitive background.…”

“…This work now introduces the high-risk clone ST235 to be the third most common clone in the P. aeruginosa population. So far, almost all publications have dealt with the infection epidemiology and antimicrobial resistance of the ExoU-positive ST235 clone (subject of 88% of publications, PubMed, search term Pseudomonas aeruginosa ST235, assessed 6 March 2020) (37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49). Antibiotic resistance determinants of MDR and extensively drugresistant (XDR) ST235 strains have been characterized in detail (40-43, 45-47, 49); otherwise, our current knowledge about the lifestyle, physiology, and metabolism of the pandemic ST235 clone is scarce (50).…”

“…The combination of mutation and import of sequences initially generated clone-specific signatures of lifestyle, genome mobility, and virulence. The drug-sensitive representatives that are the subject of this report then rapidly diversified in regional MDR and XDR sublineages (21,22,30,(38)(39)(40)(41)(42)(43)(45)(46)(47).…”