Emergence of NDM-producing Klebsiella pneumoniae and Escherichia coli in Spain: phylogeny, resistome, virulence and plasmids encoding bla(NDM)-like genes as determined by WGS
Por:
Perez-Vazquez, M, Campoy, P, Ortega, A, Bautista, V, Monzon, S, Ruiz-Carrascoso, G, Mingorance, J, Gonzalez-Barbera, E, Gimeno, C, Aracil, B, Saez, D, Lara, N, Fernandez, S, Gonzalez-Lopez, J, Campos, J, Kingsley, R, Dougan, G, Oteo-Iglesias, J, Rodrigo, C, Aznar, E, Garcia-Picazo, L, Martinez, B, Mansilla, E, Alvarez-Garcia, P, Carretero, J, Rodriguez-Conde, I, Cao, S, Gimeno, A, Moreno, M, Rodriguez, M, Cavero, T, Gil, Y, Esteras, M, Andres, J, Trujillo, G, Almaraz, J, Leon, J, del Pozo, J, Salas, C, Adan, F, Bertomeu, F, Cascales, P, Dorado, J, Suarez, C and Spanish NDM Study Grp
Publicada:
1 dic 2019
Resumen:
Objectives: NDM carbapenemases have spread worldwide. However, little information exists about the impact of NDM-producing Enterobacteriaceae in Spain. By WGS, we sought to elucidate the population structure of NDM-like-producing Klebsiella pneumoniae and Escherichia coli in Spain and to determine the plasmids harbouring bla(NDM)-like genes.
Methods: High-resolution SNP typing, core-genome MLST and plasmid reconstruction (PlasmidID) were performed on 59 NDM-like-producing K. pneumoniae and 8 NDM-like-producing E. coli isolated over an 8year period in Spain.
Results: Five major epidemic clones of NDM-producing K. pneumoniae caused five important nationwide outbreaks: ST437/NDM-7, ST437/NDM-1, ST147/NDM-1, ST11/NDM-1 and ST101/NDM-1; in contrast, the spread of NDM-producing E. coli was polyclonal. Three bla(NDM) types were identified: bla(NDM-1), 61.2%; bla(NDM-7), 32.8%; and bla(NDM-5), 6%. Five K. pneumoniae isolates co-produced other carbapenemases (three bla(OXA-48) and two bla(VIM-1)). The average number of acquired resistance genes was higher in K. pneumoniae than in E. coli. The plasmids encoding bla(NDM)-like genes belonged to IncFII, IncFIB, IncX3, IncR, IncN and IncC types, of which IncF, IncR and IncC were associated with MDR. The genetic surroundings of bla(NDM)-like genes showed a highly variable region upstream of ISAba125.
Conclusions: In recent years NDM-producing K. pneumoniae and E. coli have emerged in Spain; the spread of a few high-risk K. pneumoniae clones such as ST437/NDM-7, ST437/NDM-1, ST147/NDM-1, ST11/NDM-1 and ST101/NDM-1 have caused several interregional outbreaks. In contrast, the spread of NDM-producing E. coli has been polyclonal. Plasmid types IncFII, IncFIB, IncX3, IncR, IncN and IncC carried bla(NDM), and the same IncX3 plasmid was detected in K. pneumoniae and E. coli.
Filiaciones:
Perez-Vazquez, M:
Inst Salud Carlos III, Ctr Nacl Microbiol, Lab Referencia & Invest Resistencia Antibiot Infe, Madrid, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015 &, Madrid, Spain
Campoy, P:
Inst Salud Carlos III, Ctr Nacl Microbiol, Lab Referencia & Invest Resistencia Antibiot Infe, Madrid, Spain
Ortega, A:
Inst Salud Carlos III, Ctr Nacl Microbiol, Lab Referencia & Invest Resistencia Antibiot Infe, Madrid, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015 &, Madrid, Spain
Bautista, V:
Inst Salud Carlos III, Ctr Nacl Microbiol, Lab Referencia & Invest Resistencia Antibiot Infe, Madrid, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015 &, Madrid, Spain
Monzon, S:
Inst Salud Carlos III, Unidad Bioinformat BU ISCIII, Madrid, Spain
Ruiz-Carrascoso, G:
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015 &, Madrid, Spain
Hosp Univ La Paz IdiPAZ, Serv Microbiol, Madrid, Spain
Mingorance, J:
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015 &, Madrid, Spain
Hosp Univ La Paz IdiPAZ, Serv Microbiol, Madrid, Spain
Gonzalez-Barbera, E:
Hosp Univ La Fe, Serv Microbiol, Valencia, Spain
Gimeno, C:
Hosp Gen Univ Valencia, Serv Microbiol, Valencia, Spain
Aracil, B:
Inst Salud Carlos III, Ctr Nacl Microbiol, Lab Referencia & Invest Resistencia Antibiot Infe, Madrid, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015 &, Madrid, Spain
Saez, D:
Inst Salud Carlos III, Ctr Nacl Microbiol, Lab Referencia & Invest Resistencia Antibiot Infe, Madrid, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015 &, Madrid, Spain
Lara, N:
Inst Salud Carlos III, Ctr Nacl Microbiol, Lab Referencia & Invest Resistencia Antibiot Infe, Madrid, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015 &, Madrid, Spain
Fernandez, S:
Inst Salud Carlos III, Ctr Nacl Microbiol, Lab Referencia & Invest Resistencia Antibiot Infe, Madrid, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015 &, Madrid, Spain
Gonzalez-Lopez, J:
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015 &, Madrid, Spain
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Clin Microbiol Dept, Barcelona, Spain
Campos, J:
Inst Salud Carlos III, Ctr Nacl Microbiol, Lab Referencia & Invest Resistencia Antibiot Infe, Madrid, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015 &, Madrid, Spain
Kingsley, R:
Wellcome Trust Sanger Inst, Cambridge, England
Quadram Inst Biosci, Norwich, Norfolk, England
Dougan, G:
Wellcome Trust Sanger Inst, Cambridge, England
Oteo-Iglesias, J:
Inst Salud Carlos III, Ctr Nacl Microbiol, Lab Referencia & Invest Resistencia Antibiot Infe, Madrid, Spain
Inst Salud Carlos III, Spanish Network Res Infect Dis REIPI RD12 0015 &, Madrid, Spain
Rodrigo, C:
Hosp Cent Cruz Roja San Jose & Santa Adela, Madrid, Spain
Aznar, E:
Lab Br Salud, Madrid, Spain
Garcia-Picazo, L:
Hosp Escorial, Madrid, Spain
Martinez, B:
Hosp Univ Puerta Hierro Majadahonda, Madrid, Spain
Mansilla, E:
Hosp Univ Gregorio Maranon, Madrid, Spain
Alvarez-Garcia, P:
Complejo Hosp Pontevedra, Pontevedra, Spain
Carretero, J:
Hosp Lucus Augusta, Lugo, Spain
Rodriguez-Conde, I:
Hosp Povisa, Pontevedra, Spain
Cao, S:
Complejo Hosp Univ Vigo, Vigo, Spain
:
Hosp Gen Univ Alicante, Alicante, Spain
Moreno, M:
Hosp Verge Cinta, Tarragona, Spain
Rodriguez, M:
Hosp Txagorritxu, Vitoria, Spain
Cavero, T:
Hosp Univ La Princesa, Madrid, Spain
Gil, Y:
Hosp Mostoles, Madrid, Spain
Esteras, M:
Hosp Leon, Leon, Spain
Andres, J:
Hosp Santiago Apostol, Alava, Spain
Trujillo, G:
Hosp San Joan de Deu, Barcelona, Spain
Xarxa Assistencial Univ Manresa, Athaia, Barcelona, Spain
Almaraz, J:
Hosp Cruces, Bilbao, Vizcaya, Spain
Leon, J:
Clin Univ Navarra, Navarra, Spain
del Pozo, J:
Clin Univ Navarra, Navarra, Spain
Salas, C:
Complejo Hosp Navarra, Navarra, Spain
Adan, F:
Hosp Univ St Joan DAlacant, Alicante, Spain
Bertomeu, F:
Hosp Univ Tarragona Joan XXIII, Tarragona, Spain
Cascales, P:
Hosp Elda Virgen Salud, Alicante, Spain
Dorado, J:
MegaLab, Barcelona, Spain
Suarez, C:
Lab Dr F Echevarne, Barcelona, Spain
Open Access
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