High prevalence of ArmA-16S rRNA methyltransferase among aminoglycoside-resistant Klebsiella pneumoniae bloodstream isolates.

Autor: Isler B; University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, Brisbane, Australia.; Infection Management Services, Princess Alexandra Hospital, Brisbane, Australia., Falconer C; University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, Brisbane, Australia., Vatansever C; Infectious Diseases and Clinical Microbiology, School of Medicine, Koç University, Istanbul, Turkey., Özer B; Infectious Diseases and Clinical Microbiology, School of Medicine, Koç University, Istanbul, Turkey., Çınar G; Infectious Diseases and Clinical Microbiology, Ankara University School of Medicine, Ankara, Turkey., Aslan AT; Infectious Diseases and Clinical Microbiology, Hacettepe University School of Medicine, Ankara, Turkey., Forde B; University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, Brisbane, Australia., Harris P; University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, Brisbane, Australia., Şimşek F; Infectious Diseases and Clinical Microbiology, University of Health Sciences, Ministry of Health Prof Dr Cemil Taşçıoğlu City Hospital, Istanbul, Turkey., Tülek N; Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Atilim University, Ankara, Turkey., Demirkaya H; Infectious Diseases and Clinical Microbiology, Başkent University, Ankara Hospital, Ankara, Turkey., Menekşe Ş; Infectious Diseases, Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey., Akalin H; Infectious Diseases and Clinical Microbiology, Uludağ University School of Medicine, Bursa, Turkey., Balkan İİ; Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpaşa, School of Medicine, Istanbul, Turkey., Aydın M; Infectious Diseases and Clinical Microbiology, Ümraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey., Tigen ET; Infectious Diseases and Clinical Microbiology, Marmara University, Pendik Training and Research Hospital, Istanbul, Turkey., Demir SK; Infectious Diseases and Clinical Microbiology, Demiroglu Bilim University, Istanbul, Turkey., Kapmaz M; Infectious Diseases and Clinical Microbiology, Koç University Hospital, Istanbul, Turkey., Keske Ş; Infectious Diseases, VKV American Hospital, Istanbul, Turkey.; Infectious Diseases and Clinical Microbiology, School of Medicine, Koç University, Istanbul, Turkey., Doğan Ö; Infectious Diseases and Clinical Microbiology, School of Medicine, Koç University, Istanbul, Turkey., Arabacı Ç; Clinical Microbiology, University of Health Sciences, Ministry of Health Prof Dr Cemil Taşçıoğlu City Hospital, Istanbul, Turkey., Yağcı S; Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey., Hazırolan G; Clinical Microbiology, Hacettepe University School of Medicine, Ankara, Turkey., Bakır VO; Graduate School of Sciences and Engineering, Koç University, Istanbul, Turkey., Gönen M; Industrial Engineering, College of Engineering, Koç University, Istanbul, Turkey., Saltoğlu N; Infectious Diseases and Clinical Microbiology, Istanbul University-Cerrahpaşa, School of Medicine, Istanbul, Turkey., Azap A; Infectious Diseases and Clinical Microbiology, Ankara University School of Medicine, Ankara, Turkey., Azap Ö; Infectious Diseases and Clinical Microbiology, Başkent University, Ankara Hospital, Ankara, Turkey., Akova M; Infectious Diseases and Clinical Microbiology, Hacettepe University School of Medicine, Ankara, Turkey., Ergönül Ö; Koç University İş Bank Centre for Infectious Diseases (KUISCID), Istanbul, Turkey.; Infectious Diseases and Clinical Microbiology, School of Medicine, Koç University, Istanbul, Turkey., Can F; Koç University İş Bank Centre for Infectious Diseases (KUISCID), Istanbul, Turkey.; Infectious Diseases and Clinical Microbiology, School of Medicine, Koç University, Istanbul, Turkey., Paterson DL; University of Queensland, Faculty of Medicine, UQ Centre for Clinical Research, Brisbane, Australia.; ADVANCE ID, Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Jazyk: angličtina
Zdroj: Journal of medical microbiology [J Med Microbiol] 2022 Dec; Vol. 71 (12).
DOI: 10.1099/jmm.0.001629
Abstrakt: Introduction. Aminoglycosides are used for the treatment of carbapenemase-producing Klebsiella pneumoniae (CPK) infections. 16S rRNA methyltransferases (RMTs) confer resistance to all aminoglycosides and are often cocarried with NDM. Hypothesis/Gap Statement. There is a dart of studies looking at the aminoglycoside resistance mechanisms for invasive CPK isolates, particularly in OXA-48 endemic settings. Aim. We aimed to determine the prevalence of RMTs and their association with beta lactamases and MLSTs amongst aminoglycoside-resistant CPK bloodstream isolates in an OXA-48 endemic setting. Methodology. CPK isolates ( n =181), collected as part of a multicentre cohort study, were tested for amikacin, gentamicin and tobramycin susceptibility using custom-made sensititre plates (GN2XF, Thermo Fisher Scientific). All isolates were previously subjected to whole-genome sequencing. Carbapenemases, RMTs, MLSTs and plasmid incompatibility groups were detected on the assembled genomes. Results. Of the 181 isolates, 109(60 %) were resistant to all three aminoglycosides, and 96 of 109(88 %) aminoglycoside-resistant isolates carried an RMT (85 ArmA, 10 RmtC, 4 RmtF1; three isolates cocarried ArmA and RmtC). Main clonal types associated with ArmA were ST2096 (49/85, 58 %) and ST14 (24/85, 28 %), harbouring mainly OXA-232 and OXA-48 +NDM, respectively. RmtC was cocarried with NDM (5/10) on ST395, and NDM +OXA-48 or NDM +KPC (4/10) on ST14, ST15 and ST16. All RMT producers also carried CTX-M-15, and the majority cocarried SHV-106, TEM-150 and multiple other antibiotic resistance genes. The majority of the isolates harboured a combination of IncFIB, IncH and IncL/M type plasmids. Non-NDM producing isolates remained susceptible to ceftazidime-avibactam. Conclusion. Aminoglycoside resistance amongst CPK bloodstream isolates is extremely common and mainly driven by clonal spread of ArmA carried on ST2096 and ST14, associated with OXA-232 and OXA48 +NDM carriage, respectively.
Databáze: MEDLINE
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