Epidemiology of colistin-resistant, carbapenemase-producing Enterobacteriaceae and Acinetobacter baumannii in Croatia

Autor: Rick Conzemius, Andrea J. Grisold, Dijana Varda-Brkić, Ivan Barišić, Inge C. Gyssens, Branka Bedenić, Maja Bogdan, Valentino D’Onofrio
Rok vydání: 2020
Předmět:
0301 basic medicine
Acinetobacter baumannii
Carbapenem
Antibiotics
Colistin resistance
lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4]
Drug resistance
Drug Resistance
Multiple
Bacterial
Medicine and Health Sciences
polycyclic compounds
Phylogeny
Cross Infection
Enterobacteriaceae Infections
3. Good health
Anti-Bacterial Agents
Infectious Diseases
A. baumannii
medicine.drug
Acinetobacter Infections
Microbiology (medical)
medicine.drug_class
Croatia
carbapenems
carbapenem-hydrolyzing oxacillinase
resistance
klebsiella pneumoniae
colistin resistance
030106 microbiology
Microbial Sensitivity Tests
Biology
Microbiology
beta-Lactamases
Carbapenemase
03 medical and health sciences
Antibiotic resistance
All institutes and research themes of the Radboud University Medical Center
Bacterial Proteins
Enterobacteriaceae
Genetics
medicine
Humans
Molecular Biology
Genotyping
Ecology
Evolution
Behavior and Systematics
Molecular epidemiology
Whole Genome Sequencing
Colistin
Biology and Life Sciences
biochemical phenomena
metabolism
and nutrition
biology.organism_classification
bacterial infections and mycoses
030104 developmental biology
bacteria
Zdroj: Infection, Genetics and Evolution, 81
Infection, Genetics and Evolution
INFECTION GENETICS AND EVOLUTION
ISSN: 1567-1348
1567-7257
DOI: 10.1016/j.meegid.2020.104263
Popis: Colistin is a last-resort antibiotic for the treatment of infections caused by multidrug and carbapenem-resistant Gram-negative bacteria. Colistin resistance has been emerging and multiple outbreaks have been reported in Europe and elsewhere. It has been most frequently reported in carbapenem-resistant K. pneumoniae. In this study, 24 multidrug and colistin-resistant clinical isolates (14 K. pneumoniae, one E. aerogenes, one E. cloacae, and eight A. baumannii) were collected from four hospitals in Croatia from 2013 to 2018, in order to analyse the molecular epidemiology and mechanisms of antibiotic resistance. beta-lactamase and carbapenemase genes were detected by PCR. Genotyping was done on selected isolates by rep-PCR. Whole genome sequencing (WGS) was performed to discover possible molecular mechanisms for the observed colistin resistance. All isolates, except two K. pneumoniae isolates, were extensively drug resistant. Ten out of 16 (63%) K. pneumoniae isolates possessed bla(OXA-48), which is the most common carbapenem resistance gene in Croatia and in other parts of Europe. All A. baumannii isolates possessed the OXA-23-like carbapenem hydrolysing oxacillinase and five turned out to be pandrug-resistant. Colistin resistance was most likely chromosomally mediated. After sequence analysis, none of the isolates were found to possess any of the mcr gene variants. Several previously reported mutations were found in PmrB, PhoP, PhoQ, and MgrB, which are associated with colistin resistance. In the global phylogenetic analysis, DNA mutations causing mutations in the MgrB protein were present mostly in lineages comprising colistin resistant isolates, and the second most prevalent mutation (K3X) was also encountered in our isolates. In addition, based on genotyping by rep-PCR, the spread of colistin resistance is most likely to be clonal. Most importantly, the presence of colistin resistance together with carbapenemase genes in extensively drug resistant isolates poses real threats in the use of carbapenems and colistin to fight infections.
Databáze: OpenAIRE
Externí odkaz: