VIM/IMP carbapenemase-producing Enterobacteriaceae in Poland: epidemic Enterobacter hormaechei and Klebsiella oxytoca lineages

Izdebski, Radosław; Baraniak, Anna; Żabicka, Dorota; Sękowska, Alicja; Gospodarek‐Komkowska, Eugenia; Hryniewicz, Waleria; Gniadkowski, Marek

doi:10.1093/jac/dky257

Cited by 22 publications

(24 citation statements)

References 32 publications

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“…OXA-48-producing K. oxytoca belonging to ST95 has been previously detected in clinical specimens in the UK (Findlay et al, 2017). Other carbapenemase-producing Enterobacterales including VIM-producing E. cloacae , VIM-producing C. freundii, and NDM-producing E. coli , belonging to ST95 have also been detected in clinical specimens across the globe (Izdebski et al, 2018; Matsumura et al, 2017; Zhang et al, 2017), highlighting the clinical significance and dissemination of this sequence type.…”

Section: Discussionmentioning

confidence: 99%

Hospital effluent: A reservoir for carbapenemase-producing Enterobacterales?

Cahill

O’Connor

Mahon

et al. 2019

Science of The Total Environment

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Antimicrobial resistance is a major public health concern. Carbapenemase-producing Enterobacterales (CPE) represent a significant health threat as some strains are resistant to almost all available antibiotics. The aim of this research was to examine hospital effluent and municipal wastewater in an urban area in Ireland for CPE. Samples of hospital effluent ( n = 5), municipal wastewater before (n = 5) and after ( n = 4) the hospital effluent stream joined the municipal wastewater stream were collected over a nine-week period (May–June 2017). All samples were examined for CPE by direct plating onto Brilliance CRE agar. Isolates were selected for susceptibility testing to 15 antimicrobial agents in accordance with EUCAST criteria. Where relevant, isolates were tested for carbapenemase-encoding genes by real-time PCR. CPE were detected in five samples of hospital effluent, one sample of pre-hospital wastewater and three samples of post-hospital wastewater. Our findings suggest hospital effluent is a major contributor to CPE in municipal wastewater. Monitoring of hospital effluent for CPE could have important applications in detection and risk management of unrecognised dissemination of CPE in both the healthcare setting and the environment.

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Section: Discussionmentioning

confidence: 99%

Hospital effluent: A reservoir for carbapenemase-producing Enterobacterales?

Cahill

O’Connor

Mahon

et al. 2019

Science of The Total Environment

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“…Moreover, an epidemic survey of E. cloacae blood infection reported the presence of metallo-␤-lactamases (24). E. cloacae is the third Enterobacteriaceae in the production of carbapenemase, and several strains have been described to simultaneously express two carbapenemases (213). A report mentioned that the KPC enzyme was the most frequently identified in the SMART global surveillance program from 2008 to 2014 (214).…”

Section: Molecular Mechanisms Of Resistancementioning

confidence: 99%

Enterobacter spp.: Update on Taxonomy, Clinical Aspects, and Emerging Antimicrobial Resistance

2019

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SUMMARY The genus Enterobacter is a member of the ESKAPE group, which contains the major resistant bacterial pathogens. First described in 1960, this group member has proven to be more complex as a result of the exponential evolution of phenotypic and genotypic methods. Today, 22 species belong to the Enterobacter genus. These species are described in the environment and have been reported as opportunistic pathogens in plants, animals, and humans. The pathogenicity/virulence of this bacterium remains rather unclear due to the limited amount of work performed to date in this field. In contrast, its resistance against antibacterial agents has been extensively studied. In the face of antibiotic treatment, it is able to manage different mechanisms of resistance via various local and global regulator genes and the modulation of the expression of different proteins, including enzymes (β-lactamases, etc.) or membrane transporters, such as porins and efflux pumps. During various hospital outbreaks, the Enterobacter aerogenes and E. cloacae complex exhibited a multidrug-resistant phenotype, which has stimulated questions about the role of cascade regulation in the emergence of these well-adapted clones.

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“…The bla IMP and bla VIM genes always exist as cassettes inserted into integrons. In turn, integrons can be located on transposons and move with them between DNA molecules (Izdebski et al 2018b). ESβL enzymes exist mainly as acquired, plasmid-encoded β-lactamases.…”

Section: Mic -Minimummentioning

confidence: 99%

“…It allows them to spread rapidly, also between strains belonging to different species. Frequently noted are encoded by bla CTX-M genes ESβL enzymes, active against cefotaxime CTX-M and localized on plasmids in Enterobacterales (Izdebski et al 2018a;2018b).…”

Section: Mic -Minimummentioning

confidence: 99%

“…Significantly, an increasing problem with VIM-producing K. pneu moniae has been recorded in Greece, where the strains have accounted for the deaths of 48% of patients over the last two years (Protonotariou et al 2018). In Poland, Izdebski et al (2018b), collected one hundred and nineteen cases of VIM/IMP-positive Enterobacteriaceae in the period from 2006 to 2012, and showed many specific or entirely new features of these microorganisms, undoubtedly related to the properties of pathogens isolated in the abovementioned central-southern countries Europe, including several likely imported from abroad (e.g., from Greece) (Izdebski et al 2018b).…”

Section: Mic -Minimummentioning

confidence: 99%

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Clonal Dissemination of KPC-2, VIM-1, OXA-48-Producing Klebsiella pneumoniae ST147 in Katowice, Poland

Ochońska

Klamińska-Cebula

Dobrut

et al. 2021

Polish Journal of Microbiology

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Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an important bacterium of nosocomial infections. In this study, CRKP strains, which were mainly isolated from fecal samples of 14 patients in three wards of the hospital in the Silesia Voivodship, rapidly increased from February to August 2018. Therefore, we conducted microbiological and molecular studies of the CRKP isolates analyzed. Colonized patients had critical underlying diseases and comorbidities; one developed bloodstream infection, and five died (33.3%). Antibiotic susceptibilities were determined by the E-test method. A disc synergy test confirmed carbapenemase production. CTX-Mplex PCR evaluated the presence of resistance genes blaCTX-M-type, blaCTX-M-1, blaCTX-M-9, and the genes blaSHV, blaTEM, blaKPC-2, blaNDM-1, blaOXA-48, blaIMP, and blaVIM-1 was detected with the PCR method. Clonality was evaluated by Multi Locus Sequence Typing (MLST) and Pulsed Field Gel Electrophoresis (PFGE). Six (40%) strains were of XDR (Extensively Drug-Resistant) phenotype, and nine (60%) of the isolates exhibited MDR (Multidrug-Resistant) phenotype. The range of carbapenem minimal inhibitory concentrations (MICs, μg/mL) was as follows doripenem (16 to > 32), ertapenem (> 32), imipenem (4 to > 32), and meropenem (> 32). PCR and sequencing confirmed the blaCTX-M-15, blaKPC-2, blaOXA-48, and blaVIM-1 genes in all strains. The isolates formed one large PFGE cluster (clone A). MLST assigned them to the emerging high-risk clone of ST147 (CC147) pandemic lineage harboring the blaOXA-48 gene. This study showed that the K. pneumoniae isolates detected in the multi-profile medical centre in Katowice represented a single strain of the microorganism spreading in the hospital environment.

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VIM/IMP carbapenemase-producing Enterobacteriaceae in Poland: epidemic Enterobacter hormaechei and Klebsiella oxytoca lineages

Abstract: The epidemiology of VIM/IMP-producing Enterobacteriaceae in Poland has revealed a remarkable number of specific or novel characteristics of the organisms, with some possible links to other mid-southern European countries.

Cited by 22 publications

References 32 publications

Hospital effluent: A reservoir for carbapenemase-producing Enterobacterales?

Hospital effluent: A reservoir for carbapenemase-producing Enterobacterales?

Enterobacter spp.: Update on Taxonomy, Clinical Aspects, and Emerging Antimicrobial Resistance

Clonal Dissemination of KPC-2, VIM-1, OXA-48-Producing Klebsiella pneumoniae ST147 in Katowice, Poland

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