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Isolation of five Enterobacteriaceae species harbouring blaNDM-1 and mcr-1 plasmids from a single paediatric patient


Autoři: F. Martino aff001;  N. Tijet aff002;  R. Melano aff002;  A. Petroni aff001;  E. Heinz aff003;  D. De Belder aff001;  D. Faccone aff001;  M. Rapoport aff001;  E. Biondi aff005;  V. Rodrigo aff005;  M. Vazquez aff005;  F. Pasteran aff001;  N. R. Thomson aff003;  A. Corso aff001;  S. A. Gomez aff001
Působiště autorů: Servicio Antimicrobianos (National Reference Laboratory on Antimicrobial Resistance), Instituto Nacional de Enfermedades Infecciosas-ANLIS “Dr. Carlos G. Malbrán”, Ciudad Autónoma de Buenos Aires, Argentina aff001;  Public Health Ontario Laboratories, Toronto, Ontario, Canada aff002;  The Welcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom aff003;  Liverpool School of Tropical Medicine, Liverpool, United Kingdom aff004;  Hospital de Niños “Dr. Ricardo Gutiérrez”, Ciudad Autónoma de Buenos Aires, Argentina aff005;  London School of Hygiene and Tropical Medicine, London, United Kingdom aff006
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0221960

Souhrn

In Argentina, NDM metallo-β-lactamase was first reported in 2013. By now, it has disseminated throughout the country in diverse Gram negative bacteria. Here, we report the case of a paediatric patient that underwent a 1-year hospitalisation due to erythrodermic psoriasis in 2014 and received multiple antimicrobial treatments. During his stay, five isolates were obtained from rectal swabs (rs) or blood culture (bc) suspicious of carbapenemase production: a K. quasipneumoniae subsp. quasipneumoniae (rs), Citrobacter freundii (rs), Escherichia coli (bc), Enterobacter cloacae (rs), and a Serratia marcescens (bc). The isolates were studied with broth microdilution, biparental conjugation and plasmid and whole genome sequencing (Illumina). All isolates harboured an 138,998-bp type 1 IncC plasmid that carried blaNDM-1, bleMBL, blaCMY-6, rmtC, aac(6’)-Ib, and sul1 resistance genes. Additionally, the blaNDM-plasmids contained ISKpn8 an insertion sequence previously described as associated only to blaKPC. One isolate, a colistin-resistant E. coli, also carried a mcr-1-containing an IncI2 plasmid, which did not harbour additional resistance. The whole genome of K. quasipneumoniae subsp. quasipneumoniae isolate was fully sequenced. This isolate harboured, additionally to blaNDM, three plasmid-mediated quinolone resistance genes: qnrB4, qnrB52 and aac(6’)-Ib-cr1. The E. cloacae isolate also harboured qnrA1. These findings alert to the underestimated horizontal dissemination of multidrug-resistant plasmids limiting treatment options with last resort antimicrobials.

Klíčová slova:

Biology and life sciences – Organisms – Bacteria – Klebsiella – Enterobacteriaceae – Microbiology – Medical microbiology – Microbial pathogens – Bacterial pathogens – Microbial control – Antimicrobials – Genetics – DNA – Plasmids – Genetic elements – Genomics – Mobile genetic elements – Biochemistry – Nucleic acids – Forms of DNA – Evolutionary biology – Evolutionary systematics – Phylogenetics – Phylogenetic analysis – Taxonomy – Anatomy – Digestive system – Gastrointestinal tract – Rectum – Medicine and health sciences – Pathology and laboratory medicine – Pathogens – Pharmacology – Antimicrobial resistance – Drugs – Computer and information sciences – Data management – Physical sciences – Chemistry – Analytical chemistry – Mass spectrometry – Matrix-assisted laser desorption ionization time-of-flight mass spectrometry – Research and analysis methods – Spectrum analysis techniques


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