Molecular epidemiology of carbapenemase-producing multidrug-resistant gram-negative bacilli isolated from different infection sites

Authors

DOI:

https://doi.org/10.33448/rsd-v10i9.18070

Keywords:

Gram-negative bacteria; Carbapenemase; Resistant multidrug; Molecular epidemiology.

Abstract

Resistance to carbapenemases in gram-negative bacilli (BGN) has become a worldwide problem, increasing the rate of morbidity and mortality. The automated method was used for identification and susceptibility of isolates. And the molecular method was applied in the detection of gram-negative bacilli (BGN) producing carbapenemase. A total of 205 BGN were recovered from different carbapenemase-resistant clinical specimens. Resistance genes blaKPC (57,5%), blaVIM (30,2%), blaGES (17%), blaNDM (15%) and blaSPM (2,4%) were recovered from clinical isolates. The blaIMP gene was not detected in any of the isolates. It is worrying that Pseudomonas aeruginosa and Acinetobacter baumannii represent the majority of isolates (61.6%) recovered from infections at different sites, with high resistance to carbapenems, carrying simultaneously the blaKPC, blaGES and blaVIM genes, as well as found in Enterobactericeae. The most prevalent carbapenemase was blaKPC and blaVIM, followed by blaNDM among the resistant multidrug isolates. These results are a threat to public health, configuring high rates of resistance, limiting therapeutic options.

References

Agyepong, N., et al. (2018). Multidrug-resistant gram-negative bacterial infections in a teaching hospital in Ghana. Antimicrob Resist Infect Control. 9;7:37.

Araújo B. F., et al. (2018). Hypervirulence and biofilm production in KPC-2-producing Klebsiella pneumoniae CG258 isolated in Brazil. J Med Microbiol. 67(4):523-528.

Baek, J. Y., et al. (2019). Plasmid analysis of Escherichia coli isolates from South Korea co-producing NDM-5 and OXA-181 carbapenemases. Plasmid. 104:102417.

Barbarini, D., et al. (2015). Evaluation of carbapenem-resistant Enterobacteriaceae in an Italian setting: report from the trench. Infect Genet Evol. 30:8-14.

Ben Helal, R., et al. (2018). Occurrence and Characterization of Carbapenemase-Producing Enterobacteriaceae in a Tunisian Hospital. Microb Drug Resist. 24(9):1361-1367.

Benmahmod, A. B, et al. (2019). Prevalence and Mechanisms of Carbapenem Resistance Among Acinetobacter baumannii Clinical Isolates in Egypt. Microb Drug Resist. 25(4):480-488.

Brink, A. J. (2019). Epidemiology of carbapenem-resistant Gram-negative infections globally. Curr Opin Infect Dis. 32(6):609-616.

Carvalho-Assef, A. P, et al. (2013). Isolation of Providencia rettgeri producing NDM in Brazil. J Antimicrob Chemother. 68: 2956 - 2957.

Castanheira, M, et al.. (2020). Meropenem-Vaborbactam Activity against Carbapenem-Resistant Enterobacterales Isolates Collected in U.S. Hospitals during 2016 to 2018. Antimicrob Agents Chemother. 64(2). pii: e01951-19.

Cuaical-Ramos, N. M, et al. (2019). Genetic variability of carbapenemase KPC-producing Klebsiella pneumoniae isolated at different states in Venezuela. Variabilidad genética de Klebsiella pneumoniae con carbapenemasa tipo KPC proveniente de diferentes estados de Venezuela. Enferm Infecc Microbiol Clin. 37(2):76-81.

Dirar, M, et al.. (2020). Resistance Patterns and Phenotypic Detection of β-lactamase Enzymes among Enterobacteriaceae Isolates from Referral Hospitals in Khartoum State, Sudan. Cureus. 13;12(3):e7260.

Dretler, A.W, et al. (2020). High Rates of New Delhi Metallo-β-Lactamase Carbapenemase Genes in Multi-Drug Resistant Gram-Negative Bacteria in Nicaragua. Am J Trop Med Hyg. 102(2):384-387.

Escandón-Vargas, K, et al. (2017). The epidemiology of carbapenemases in Latin America and the Caribbean. Expert Rev Anti Infect Ther. 15(3):277-297.

Ferreira, A M, et al. (2016). First report of a clinical isolate of Klebsiella pneumoniae producing metallo-β-lactamase in New Delhi in Brazil. J Hosp Infect. 94: 73-74.

Firmo, E. F, et al. (2019). Association of blaNDM-1 with blaKPC-2 and aminoglycoside-modifying enzymes genes among Klebsiellapneumoniae, Proteus mirabilis and Serratiamarcescens clinical isolates in Brazil. J GlobAntimicrobResist. 21:255-61

Firmo, E. F, et al. (2020). Association of blaNDM-1 with blaKPC-2 and aminoglycoside-modifying enzyme genes among Klebsiella pneumoniae, Proteus mirabilis and Serratia marcescens clinical isolates in Brazil. J Glob Antimicrob Resist. 21:255-261

Flores, C, et al. (2020). Genetic Relatedness of NDM-Producing Klebsiella pneumoniae Co-Occurring VIM, KPC, and OXA-48 Enzymes from Surveillance Cultures from an Intensive Care Unit. Microb Drug Resist. 26(10):1219-1226

Girija, S A, et al. (2018). Prevalence of VIM- and GIM-producing Acinetobacter baumannii from patients with severe urinary tract infection. Acta Microbiol Immunol Hung. 65(4):539-550

Hagemann, J. B, et al. (2018). KPC-2 carbapenemase-producing Pseudomonas aeruginosa reaching Germany. J Antimicrob Chemother. 1;73(7):1812-1814

Hassuna, N. A, et al. (2020). Molecular Epidemiology and Mechanisms of High-Level Resistance to Meropenem and Imipenem in Pseudomonas aeruginosa. Infect Drug Resist. 13:285-293

Iovleva, A., & Doi, Y. (2017). Carbapenem-Resistant Enterobacteriaceae. Clin Lab Med. 37(2):303-315

Kiaei, S, et al.. (2019). Emergence of co-existence of blaNDM with rmtC and qnrB genes in clinical carbapenem-resistant Klebsiella pneumoniae isolates in burning center from southeast of Iran. Folia Microbiol (Praha). 64(1):55-62

Labarca, J. A., et al. (2016). Carbapenem resistance in Pseudomonas aeruginosa and Acinetobacter baumannii in the nosocomial setting in Latin America. Crit Rev Microbiol. 42(2):276-92

Logan, L. K., & Weinstein, R. A. (2017). The Epidemiology of Carbapenem-Resistant Enterobacteriaceae: The Impact and Evolution of a Global Menace. J Infect Dis. 15;215(suppl_1):S28-S36

Lopes, E, et al. (2020). Epidemiology of carbapenemase-producing Klebsiella pneumoniae in northern Portugal: Predominance of KPC-2 and OXA-48. J Glob Antimicrob Resist. (20):30101-6

Mendes, R. E., et al. (2007). Rapid detection and identification of metallo-beta-lactamase-encoding genes by multiplex real-time PCR assay and melt curve analysis. J ClinMicrobiol. 45(2):544-7. 10.1128/JCM.01728-06.

Merradi, M, et al. (2019). Occurrence of VIM-4 metallo-β-lactamase-producing Pseudomonas aeruginosa in an Algerian hospital. J Infect Dev Ctries. 13(4):284-290.

Mohapatra, D. P, et al.. (2018). Extensively drug-resistant and pandrug-resistant Gram-negative bacteria in a tertiary-care hospital in Eastern India: A 4-year retrospective study. J Glob Antimicrob Resist. 15:246-249

Nordmann, P., et al. (2011). Global spread of carbapenemase producing Enterobacteriaceae. Emerg Infect Dis 17:1791–1798

Nordmann, P., & Poirel, L. (2019). Epidemiology and Diagnostics of Carbapenem Resistance in Gram-negative Bacteria. Clin Infect Dis. 13;69(Suppl 7):S521-S528

Oteo, J, et al. (2013). Spanish Collaborating Group for the Antibiotic Resistance Surveillance Program. Carbapenemase-producing enterobacteriaceae in Spain in 2012. Antimicrob Agents Chemother. 57(12):6344-7.

Pacheco, T., et al. (2019). Pseudomonas aeruginosa Coharboring BlaKPC-2 and BlaVIM-2 Carbapenemase Genes. Antibiotics (Basel) 20;8(3). pii: E98.

Papadimitriou-Olivgeris. M, et al. (2019). Reversal of carbapenemase-producing Klebsiella pneumoniae epidemiology from blaKPC- to blaVIM-harbouring isolates in a Greek ICU after introduction of ceftazidime/avibactam. J Antimicrob Chemother. 1;74(7):2051-2054

Peirano, G, et al. (2018). Genomic epidemiology of global Carbapenemase - producer of Enterobacter spp., 2008-2014. Emerg Infect Dis. (6):1010-1019

Petrova, A. P, et al. (2017). Carbapenemase Production of Clinical Isolates Acinetobacter baumannii and Pseudomonas aeruginosa from a Bulgarian University Hospital. Folia Med (Plovdiv). 20;59(4):413-422.

Poirel, L., et al. (2012). Genetic Features of the Widespread Plasmid Coding for the Carbapenemase OXA-48. Antimicrob Agents Chemother. 56 (1): 559-562. 10.1128 / AAC.05289-11

Sah, R, et al. (2019). Detection of Pan drug resistance OXA-48 producing Providencia in an ICU patient for the first time in Nepal. AntimicrobResistInfectControl. 8:155.

Senchyna, F, et al. (2019). Diversity of resistance mechanisms in carbapenem-resistant Enterobacteriaceae at a health care system in Northern California, from 2013 to 2016. Diagn Microbiol Infect Dis. 93(3):250-257

Simner, P. J, et al. (2017). Carbapenemase Detection among Carbapenem-Resistant Glucose-Nonfermenting Gram-Negative Bacilli. J Clin Microbiol. 55(9):2858-2864.

Soares, C. R. P., et al. (2020). First report of a blaNDM-resistant gene in a Klebsiella aerogenes clinical isolate from Brazil. Journal of the Brazilian Society of Tropical Medicine. 21;54:e02622020.

Soliman, A. M, et al. (2020). Genetic analysis of carbapenemase-producing Gram-negative bacteria isolated from a university teaching hospital in Egypt. Infect Genet Evol. 77:104065.

Telling, K., et al. (2018). Multidrug resistant Pseudomonas aeruginosa in Estonian hospitals. BMC Infect Dis. 11;18(1):513

Tian D, et al. (2020). Dissemination of the bla NDM-5 Gene via IncX3-Type Plasmid among Enterobacteriaceae in Children. mSphere. 5(1). pii: e00699-19

Uc-Cachón, A. H., et al.. (2019). High Prevalence of Antimicrobial Resistance Among Gram-Negative Isolated Bacilli in Intensive Care Units at a Tertiary-Care Hospital in Yucatán Mexico. Medicina (Kaunas). 13;55(9):588

Wang, C, et al. (2006). An isolate of Pseudomonas aeruginosa that produces the extended spectrum beta-lactamase GES-5. J Antimicrob Chemother. 57 (6): 1261-2. 10.1093 / jac / dkl116

Wang, Q, et al. (2018). Phenotypic and Genotypic Characterization of Carbapenem-resistant Enterobacteriaceae: Data From a Longitudinal Large-scale CRE Study in China (2012-2016). Clin Infect Dis. 13;67(suppl_2):S196-S205

Wilson, H., & Török, M. E. (2018). Extended-spectrum β-lactamase-producing and carbapenemase-producing Enterobacteriaceae. Microb Genom. 4(7):e000197.

Yaghi, J, et al. (2020). Unusually High Prevalence of Cosecretion of Ambler Class A and B Carbapenemases and Nonenzymatic Mechanisms in Multidrug-Resistant Clinical Isolates of Pseudomonas aeruginosa in Lebanon. Microb Drug Resist. 26(2):150-159

Yan, J, et al. (2017). Multidrug Resistance Mechanisms of Carbapenem Resistant Klebsiella pneumoniae Strains Isolated in Chongqing, China. Ann Lab Med. 37(5):398-407

Zeynudin, A., et al.. (2018). Prevalence and antibiotic susceptibility pattern of CTX-M type extended-spectrum β-lactamases among clinical isolates of gram-negative bacilli in Jimma, Ethiopia. BMC Infect Dis. 20;18(1):524

Zhang, Y., et al. (2018). Epidemiology of Carbapenem-Resistant Enterobacteriaceae Infections: Report from the China CRE Network. Antimicrob Agents Chemother. 25;62(2):e01882-17

Published

26/07/2021

How to Cite

SOARES, C. R. P. .; SILVA , F. R. F. da .; OLIVEIRA JÚNIOR, J. B. .; ARAÚJO, P. S. R. de .; FIRMO, E. F. . Molecular epidemiology of carbapenemase-producing multidrug-resistant gram-negative bacilli isolated from different infection sites. Research, Society and Development, [S. l.], v. 10, n. 9, p. e30210918070, 2021. DOI: 10.33448/rsd-v10i9.18070. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/18070. Acesso em: 22 nov. 2024.

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Section

Health Sciences