Intrinsic Resistance to Colistin in the Genus Hafnia .

Autor:	Turbett SE; Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA.; Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Department of Medicine, Boston, Massachusetts, USA.; Harvard Medical School, Department of Pathology, Boston, Massachusetts, USA., Bronson RA; Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Boston, Massachusetts, USA., Worby CJ; Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Boston, Massachusetts, USA., McGrath GEG; Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Hodgkins E; Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA., Becker M; Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA., Belford B; Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA., Kogut L; Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Oliver E; Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Ryan ET; Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Department of Medicine, Boston, Massachusetts, USA., LaRocque RC; Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Department of Medicine, Boston, Massachusetts, USA., Earl AM; Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Boston, Massachusetts, USA., Pierce VM; Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Department of Pathology, Boston, Massachusetts, USA.; Pediatric Infectious Disease Unit, MassGeneral Hospital for Children, Boston, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	Journal of clinical microbiology [J Clin Microbiol] 2023 May 23; Vol. 61 (5), pp. e0132622. Date of Electronic Publication: 2023 Apr 06.
DOI:	10.1128/jcm.01326-22
Abstrakt:	A bacterial species is considered to be intrinsically resistant to an antimicrobial when nearly all of the wild-type isolates (i.e., those without acquired resistance) exhibit minimum inhibitory concentration (MIC) values that are sufficiently high such that susceptibility testing is unnecessary, and that the antimicrobial should not be considered for therapy. Accordingly, knowledge of intrinsic resistance influences both the selection of treatment regimens and the approach to susceptibility testing in the clinical laboratory, where unexpected results also facilitate the recognition of microbial identification or susceptibility testing errors. Previously, limited data have suggested that Hafnia spp. may be intrinsically resistant to colistin. We evaluated the in vitro activity of colistin against 119 Hafniaceae that were isolated from human samples: 75 (63%) from routine clinical cultures and 44 (37%) from stool samples of travelers undergoing screening for antimicrobial resistant organisms. Broth microdilution colistin MICs were ≥4 μg/mL for 117 of 119 (98%) isolates. Whole-genome sequencing of 96 of the isolates demonstrated that the colistin-resistant phenotype was not lineage-specific. 2 of the 96 (2%) isolates harbored mobile colistin resistance genes. Compared to whole-genome sequencing, VITEK MS matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and VITEK 2 GN ID failed to consistently distinguish between Hafnia alvei, Hafnia paralvei, and Obesumbacterium proteus. In conclusion, using a reference antimicrobial susceptibility testing method and a genetically diverse collection of isolates, we found Hafnia spp. to be intrinsically resistant to colistin. The recognition of this phenotype will help inform rational approaches by which to perform antimicrobial susceptibility testing and therapy for patients with infections that are caused by Hafnia spp. Competing Interests: The authors declare a conflict of interest. S.E.T., R.C.L., and V.M.P. receive royalties from UpToDate. R.C.L. also received payments for editorial services from the CDC Foundation. V.M.P. is a member of the Clinical and Laboratory Standards Institute Subcommittee on Antimicrobial Susceptibility Testing.
Databáze:	MEDLINE
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