Background and objectives: Particularly concerning has been the recent acquisition by Enterobacteriacee of carpapenemases, i.e. enzymes able to inactivate most beta-lactams, including last resort antibiotics such as carbapenems. Whole-genome sequencing (WGS) can play a significant role in rapid and accurate differentiation of the existing and emerging carbapenemases, which will be essential for surveillance and controlling their spread. We characterized the occurrence of carbapenemase genes and extended-spectrum ß-lactamase (ESBL) genes in 10 multidrug-resistant (MDR) Klebsiella pneumoniae isolates from Pakistan. Materials and methods: The resistance profiles for the isolates were determined using Vitek. WGS data from sequencing on Illumina platforms was used for multilocus sequence typing (MLST), as well as antimicrobial resistance gene and plasmid replicon sequence analyses. Results: Resistance was observed for 15 of the 25 tested antibiotics in all strains except one. Seven isolates were resistant to colistin, and all were susceptible to tigecycline. The highest number of resistance genes was observed for aminoglycosides (n=12) and beta-lactams (n=11), with at least two genes of each class present in every isolate. The blaNDM-1 and blaOXA-48 genes were detected in 7 and 5 samples, respectively. In 2 isolates, both genes were present. Several ESBL genes were identified: blaCTX-M-15, blaTEM-1B, blaSHV-11 and blaSHV-28. No plasmid-mediated colistin resistance genes were detected, but disruptions in chromosomal loci (i.e. mgrB and pmrB) were observed. Six sequence types (STs) were detected: ST11 (n=3 isolates), ST14 (n=3), ST15 (n=1), ST101 (n=2), and ST307 (n=1). The IncL/M (pOXA-48) replicon, indicating the presence of a ~60kb plasmid carrying no other resistance genes, was found in the OXA-48 positive isolates. Conclusion: The numerous potential transmission routes at the human-animal-environment interface underline the importance of the One Health approach for effective control and prevention. Global movement of people, animals and food is amplifying the geographic distribution of MDR isolates making antibiotic resistance a borders-transcending issue, requiring international cooperation among institutions and multidisciplinary approach for its control. WGS-applying molecular epidemiology studies will provide a better understanding of the worldwide dissemination of MDR isolates and a surveillance tool useful in detecting possible new emerging threats.

Resistome of multidrug resistant Klebsiella pneumoniae

LOMONACO, Sara;
2017-01-01

Abstract

Background and objectives: Particularly concerning has been the recent acquisition by Enterobacteriacee of carpapenemases, i.e. enzymes able to inactivate most beta-lactams, including last resort antibiotics such as carbapenems. Whole-genome sequencing (WGS) can play a significant role in rapid and accurate differentiation of the existing and emerging carbapenemases, which will be essential for surveillance and controlling their spread. We characterized the occurrence of carbapenemase genes and extended-spectrum ß-lactamase (ESBL) genes in 10 multidrug-resistant (MDR) Klebsiella pneumoniae isolates from Pakistan. Materials and methods: The resistance profiles for the isolates were determined using Vitek. WGS data from sequencing on Illumina platforms was used for multilocus sequence typing (MLST), as well as antimicrobial resistance gene and plasmid replicon sequence analyses. Results: Resistance was observed for 15 of the 25 tested antibiotics in all strains except one. Seven isolates were resistant to colistin, and all were susceptible to tigecycline. The highest number of resistance genes was observed for aminoglycosides (n=12) and beta-lactams (n=11), with at least two genes of each class present in every isolate. The blaNDM-1 and blaOXA-48 genes were detected in 7 and 5 samples, respectively. In 2 isolates, both genes were present. Several ESBL genes were identified: blaCTX-M-15, blaTEM-1B, blaSHV-11 and blaSHV-28. No plasmid-mediated colistin resistance genes were detected, but disruptions in chromosomal loci (i.e. mgrB and pmrB) were observed. Six sequence types (STs) were detected: ST11 (n=3 isolates), ST14 (n=3), ST15 (n=1), ST101 (n=2), and ST307 (n=1). The IncL/M (pOXA-48) replicon, indicating the presence of a ~60kb plasmid carrying no other resistance genes, was found in the OXA-48 positive isolates. Conclusion: The numerous potential transmission routes at the human-animal-environment interface underline the importance of the One Health approach for effective control and prevention. Global movement of people, animals and food is amplifying the geographic distribution of MDR isolates making antibiotic resistance a borders-transcending issue, requiring international cooperation among institutions and multidisciplinary approach for its control. WGS-applying molecular epidemiology studies will provide a better understanding of the worldwide dissemination of MDR isolates and a surveillance tool useful in detecting possible new emerging threats.
2017
7th ARAE – Symposium on Antimicrobial Resistance in Animals and the Environment
Braunschweig, Germany
26 - 28 Giugno 2017
ARAE 2017- Proceedings
1
167
Sara, Lomonaco; Matthew, Crawford; Christine, Lascols; Ruth, Timme; Kevin, Anderson; Dave, Hodge; Segaran, Pillai; Stephen, Morse; Erum, Khan; Molly, Hughes; Marc, Allard; Shashi, Sharma
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/1646130
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