ST147 NDM-1-producing<i>Klebsiella pneumoniae</i>spread in two Tunisian hospitals: Table 1.

Messaoudi, Aziza; Haenni, Marisa; Mansour, Wejdène; Saras, Estelle; Khalifa, Anis Bel Haj; Chaouch, Cherifa; Naija, Walid; Boujaafar, N.; Bouallègue, Olfa; Madec, Jean‐Yves

doi:10.1093/jac/dkw401

Cited by 36 publications

(38 citation statements)

References 9 publications

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“…We could not find any of the targeted genes in the 2 carbapenem-resistant isolates, so their resistance to carbapenems may be due to other mechanisms including production of extendedspectrum beta-lactamases (ESBLs), AmpC betalactamases, decreased permeability of outer membrane or efflux pumps activity, or probably the presence of other genes that were not studied in this research (51) .Concurrent presence of carbapenemic genes in bacteria causes many concerns for physicians in the hospital as they cause hydrolysis of all β-lactam antibiotics as an important treatment option. Furthermore, the transfer of these genes among carriers and patients admitted in hospital increases the prevalence of the disease, which is difficult to control (52,53).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Phenotypic and Genotypic Characteristics of Carbapnemases-producing Enterobacteriaceae and Its Prevalence in a Referral Hospital in Tehran City

Jalalvand¹,

Shayanfar²,

Shahcheraghi³

et al. 2020

Iran J Pathol

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Section: Discussionmentioning

confidence: 99%

Evaluation of Phenotypic and Genotypic Characteristics of Carbapnemases-producing Enterobacteriaceae and Its Prevalence in a Referral Hospital in Tehran City

Jalalvand¹,

Shayanfar²,

Shahcheraghi³

et al. 2020

Iran J Pathol

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“…A same IncF combination ( ie . F31:A4:B1) plasmid carrying bla CTX-M-15 has regularly been identified in ST617 and ST131 isolates in Tunisia and different countries worldwide and from various samples (30). It will be interesting to perform the whole-sequencing of our plasmids to analyze their genetic relationship and evolution and to know if the acquisition of CTX-M-27 in a CTX-M-15-mediated plasmid in ST617 and S131 could be the result of independent events.…”

Section: Discussionmentioning

confidence: 99%

“…In Tunisia, several studies reported the presence of ESBLs in Enterobacteriaceae (12, 13). The presence of K. pneumonia- NDM-1 positive strains were found in Tunisian Hospitals and suspected to be also present in community (30, 31). Thus, the need for systematic monitoring of ESBL- and carbapenemase-mediated resistance in Hospital and community settings is important.…”

Section: Introductionmentioning

confidence: 99%

Emergence of B2-ST131-C2 and A-ST617 Escherichia coli clones producing both CTX-M-15- and CTX-M-27 and ST147 NDM-1 positive Klebsiella pneumoniae in the Tunisian community

Mhaya

Trabelsi

Bégu

et al. 2019

Preprint

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25CTX-M ESBLs have been increasingly reported from human enterobacteria isolates in 26 Tunisia. NDM-1 carbapenemase was recently reported in isolates from Tunisian Hospitals. 27 During a 2-month period (December 2017 to January 2018), we have collected 23 ESBL- 28 producing Enterobacteriaceae (ESBL-E) from urines of patients hospitalized in three health 29 care facilities and from community, situated in two distinct Tunisian geographical regions. 30 They were divided into 15 Escherichia coli and eight Klebsiella pneumoniae. The aim of this 31 study was to characterize ESBL-E with regard to their β-lactamase content and their 32 epidemiological relationship. The results indicated a high rate (47%) of E. coli producing both 33 CTX-M group-1 and -9. For the first time, we demonstrated the presence of E. coli having 34 concomitantly CTX-M-15 and CTX-M-27 which belong to two sequences types (ST), ie. A-35 ST617 (2 isolates) and B2-ST131 subclade C2 (2 isolates). All four E. coli isolates carried a 36 multireplicon IncF with an identical allelic combination, F31:A4:B1. This study reports also 37 the first description of K. pneumoniae belonging to the clone ST147 carrying the 38 carbapenemase NDM-1 in the Tunisian community. In conclusion, our data confirms the need 39 for monitoring the resistance to extended-spectrum cephalosporins and to carbapenems 40 among enterobacteria in Tunisia. 41 42 43Resistance to extended-spectrum cephalosporins (ESC) is widespread among 44 Enterobacteriaceae species and is mainly due to the production of extended-spectrum ß-45 lactamases (ESBLs). The dissemination of ESBLs is become a growing concern since they 46 are considered as a major cause of morbidity and mortality. Up to the end of the 1990s, TEM-47 and SHV-type ESBLs were mainly produced by the Klebsiella pneumoniae and Enterobacter 48 spp. responsible for nosocomial infections (1, 2). Since 2000s, CTX-M ESBLs have gained 49 prominence mainly in Escherichia coli and K. pneumoniae strains and are now considered as 50 pandemic enzymes. Many bla CTX-M variants exist, but they can be divided into two main 51 clusters (groups -1 and -9); each cluster of CTX-M genotypes has a corresponding progenitor 52 gene sharing homology with different environmental Kluyvera spp. from which bla CTX-M 53 genes originated. Among CTX-M enzymes, CTX-M-15 belonging to group 1, has currently 54 been the most frequent all over the world (1, 3) 55 The majority of CTX-M type ESBL-associated E. coli infections is often concentrated within 56 specific extraintestinal pathogenic E. coli (ExPEC) lineages belonging to highly virulent 57 phylogenetic group B2, and recognizable by their sequence type (ST). The bla CTX-M-15 is the 58 dominant ESBL gene in the virulent E. coli ST131 clone, in particular in the subclade ST131-59 C2 (4). However other genetically divergent CTX-M genes also occur in this ST, such as 60 bla CTX-M-14/14-like variants in Canada, China, and Spain (5, 6). A subclade of E. coli ST131 61 producing the CTX-M-27 (group 9 enzyme, CTX-M-1...

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“…It is of particular concern that representatives of the K. pneumoniae ST147 clone, well known for its epidemic potential (4,6), not only are present in the UAE as dual-carbapenemase-producing isolates but also develop resistance to the last-resort antibiotic, colistin, by insertion of a functional carbapenemase gene into the mgrB gene. Apart from the earlier report on MS6671 (12), a similar ISEcp1-driven insertional mutation of mgrB in K. pneumoniae has been observed in a single isolate in France, but in that case, an extended-spectrum betalactamase gene (bla CTX-M-15 ) was coded on the insertion, and the strain remained susceptible to an array of antibiotics (19).…”

Section: Pan-resistant Klebsiella Pneumoniae Clone In the Uaementioning

confidence: 99%

“…production of various carbapenemases, such as KPC, NDM, VIM, and various alleles of OXA-type enzymes (3)(4)(5)(6).…”

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confidence: 99%

Multihospital Occurrence of Pan-Resistant Klebsiella pneumoniae Sequence Type 147 with an IS Ecp1 -Directed bla _OXA-181 Insertion in the mgrB Gene in the United Arab Emirates

Sonnevend

Ghazawi

Hashmey

et al. 2017

Antimicrob Agents Chemother

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The emergence of pan-resistant Klebsiella pneumoniae strains is an increasing concern. In the present study, we describe a cluster of 9 pan-resistant K. pneumoniae sequence type 147 (ST147) isolates encountered in 4 patients over nearly 1 year in 3 hospitals of the United Arab Emirates (UAE). The isolates exhibited highly similar genotypes. All produced chromosomally encoded OXA-181, and the majority also produced the NDM-5 carbapenemase. As with the previously described single isolate from the UAE, MS6671, the mgrB was disrupted by a functional, ISEcp1-driven bla OXA-181 insertion causing resistance to carbapenems. The mutation was successfully complemented with an intact mgrB gene, indicating that it was responsible for colistin resistance. bla NDM-5 was located within a resistance island of an approximately 100-kb IncFII plasmid carrying ermB, mph(A), bla TEM-1B , rmtB, bla NDM-5 , sul1, aadA2, and dfrA12 resistance genes. Sequencing this plasmid (pABC143-NDM) revealed that its backbone was nearly identical to that of plasmid pMS6671E from which several resistance genes, including bla NDM-5 , had been deleted. More extensive similarities of the backbone and the resistance island were found between pABC143C-NDM and the bla NDM-5 -carrying IncFII plasmids of two K. pneumoniae ST147 isolates from South Korea, one of which was colistin resistant, and both also produced OXA-181. Notably, one of these strains was isolated from a patient transferred from the UAE. Our data show that this pan-resistant clone has an alarming capacity to maintain itself over an extended period of time and is even likely to be transmitted internationally.

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ST147 NDM-1-producingKlebsiella pneumoniaespread in two Tunisian hospitals: Table 1.

Cited by 36 publications

References 9 publications

Evaluation of Phenotypic and Genotypic Characteristics of Carbapnemases-producing Enterobacteriaceae and Its Prevalence in a Referral Hospital in Tehran City

Evaluation of Phenotypic and Genotypic Characteristics of Carbapnemases-producing Enterobacteriaceae and Its Prevalence in a Referral Hospital in Tehran City

Emergence of B2-ST131-C2 and A-ST617 Escherichia coli clones producing both CTX-M-15- and CTX-M-27 and ST147 NDM-1 positive Klebsiella pneumoniae in the Tunisian community

Multihospital Occurrence of Pan-Resistant Klebsiella pneumoniae Sequence Type 147 with an IS Ecp1 -Directed bla _OXA-181 Insertion in the mgrB Gene in the United Arab Emirates

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ST147 NDM-1-producingKlebsiella pneumoniaespread in two Tunisian hospitals: Table 1.

Cited by 36 publications

References 9 publications

Evaluation of Phenotypic and Genotypic Characteristics of Carbapnemases-producing Enterobacteriaceae and Its Prevalence in a Referral Hospital in Tehran City

Evaluation of Phenotypic and Genotypic Characteristics of Carbapnemases-producing Enterobacteriaceae and Its Prevalence in a Referral Hospital in Tehran City

Emergence of B2-ST131-C2 and A-ST617 Escherichia coli clones producing both CTX-M-15- and CTX-M-27 and ST147 NDM-1 positive Klebsiella pneumoniae in the Tunisian community

Multihospital Occurrence of Pan-Resistant Klebsiella pneumoniae Sequence Type 147 with an IS Ecp1 -Directed bla OXA-181 Insertion in the mgrB Gene in the United Arab Emirates

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Multihospital Occurrence of Pan-Resistant Klebsiella pneumoniae Sequence Type 147 with an IS Ecp1 -Directed bla _OXA-181 Insertion in the mgrB Gene in the United Arab Emirates