1887

Abstract

In recent years, has emerged as an important agent of hospital-acquired infections, such as pneumonia, urinary tract infection, septicaemia and meningitis, particularly in vulnerable patients. Compared to and , is less commonly associated with genes, yet few cases of plasmid transmission at the gastrointestinal level from carbapenemase (KPC)-producing to have been described. Here we report a case of acquisition, during a 3-month period of hospitalization in the intensive care unit, of a gene carried by a pKpQIL-IT plasmid, and its probable transmission at the bronchial level among different species of , including and . By using whole genome sequence analyses we were able provide insight into the dynamics of carbapenem-resistance determinants acquisition in the lower respiratory tract, a novel anatomical region for such plasmid transmission events, that usually involve the gastrointestinal tract. The co-presence at the same time of both wild-type and resistant could have been the critical factor leading to the spread of plasmids harbouring carbapenem-resistance genes, of particular importance during surveillance screenings. The possibility of such an event may have significant consequences in terms of antimicrobial treatment, with a potential limitation of therapeutic options, thereby further complicating the clinical management of high-risk critically ill patients.

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/content/journal/jmm/10.1099/jmm.0.001113
2020-01-06
2020-01-24
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References

  1. Montagnani C, Cocchi P, Lega L, Campana S, Biermann KP et al. Serratia marcescens outbreak in a neonatal intensive care unit: crucial role of implementing hand hygiene among external consultants. BMC Infect Dis 2015;15: 11 [CrossRef]
    [Google Scholar]
  2. Phan HTT, Stoesser N, Maciuca IE, Toma F, Szekely E et al. Illumina short-read and MinION long-read WGS to characterize the molecular epidemiology of an NDM-1 Serratia marcescens outbreak in Romania. J Antimicrob Chemother 2018;73: 672– 679 [CrossRef]
    [Google Scholar]
  3. De Belder D, Lucero C, Rapoport M, Rosato A, Faccone D et al. Genetic diversity of KPC-producing Escherichia coli, Klebsiella oxytoca, Serratia marcescens, and Citrobacter freundii isolates from Argentina. Microb Drug Resist 2018;24: 958– 965 [CrossRef]
    [Google Scholar]
  4. Gona F, Caio C, Iannolo G, Monaco F, Di Mento G et al. Detection of the IncX3 plasmid carrying blaKPC-3 in a Serratia marcescens strain isolated from a kidney-liver transplanted patient. J Med Microbiol 2017;66: 1454– 1456 [CrossRef]
    [Google Scholar]
  5. Lin X, Hu Q, Zhang R, Hu Y, Xu X et al. Emergence of Serratia marcescens isolates possessing carbapenem-hydrolysing β-lactamase KPC-2 from China. J Hosp Infect 2016;94: 65– 67 [CrossRef]
    [Google Scholar]
  6. Sidjabat HE, Silveira FP, Potoski BA, Abu-Elmagd KM, Adams-Haduch JM et al. Interspecies spread of Klebsiella pneumoniae carbapenemase gene in a single patient. Clin Infect Dis 2009;49: 1736– 1738 [CrossRef]
    [Google Scholar]
  7. Tsakris A, Voulgari E, Poulou A, Kimouli M, Pournaras S et al. In vivo acquisition of a plasmid-mediated bla(KPC-2) gene among clonal isolates of Serratia marcescens. J Clin Microbiol 2010;48: 2546– 2549 [CrossRef]
    [Google Scholar]
  8. Kim SB, Jeon YD, Kim JH, Kim JK, Ann HW et al. Risk factors for mortality in patients with Serratia marcescens bacteremia. Yonsei Med J 2015;56: 348– 354 [CrossRef]
    [Google Scholar]
  9. Nurk S, Bankevich A, Antipov D, Gurevich AA, Korobeynikov A et al. Assembling single-cell genomes and mini-metagenomes from chimeric MDA products. J Comput Biol 2013;20: 714– 737 [CrossRef]
    [Google Scholar]
  10. Inouye M, Dashnow H, Raven L-A, Schultz MB, Pope BJ et al. SRST2: rapid genomic surveillance for public health and hospital microbiology Labs. Genome Med 2014;6: 90 [CrossRef]
    [Google Scholar]
  11. Gupta SK, Padmanabhan BR, Diene SM, Lopez-Rojas R, Kempf M et al. ARG-ANNOT, a new bioinformatic tool to discover antibiotic resistance genes in bacterial genomes. Antimicrob Agents Chemother 2014;58: 212– 220 [CrossRef]
    [Google Scholar]
  12. McKenna A, Hanna M, Banks E, Sivachenko A, Cibulskis K et al. The genome analysis toolkit: a MapReduce framework for analyzing next-generation DNA sequencing data. Genome Res 2010;20: 1297– 1303 [CrossRef]
    [Google Scholar]
  13. Kurtz S, Phillippy A, Delcher AL, Smoot M, Shumway M et al. Versatile and open software for comparing large genomes. Genome Biol 2004;5: R12 [CrossRef]
    [Google Scholar]
  14. Akhter S, Aziz RK, Edwards RA. PhiSpy: a novel algorithm for finding prophages in bacterial genomes that combines similarity- and composition-based strategies. Nucleic Acids Res 2012;40: e126 [CrossRef]
    [Google Scholar]
  15. Stamatakis A. RAxML version 8: a tool for phylogenetic analysis and post-analysis of large phylogenies. Bioinformatics 2014;30: 1312– 1313 [CrossRef]
    [Google Scholar]
  16. Posada D, Using M. Using MODELTEST and PAUP* to select a model of nucleotide substitution. Curr Protoc Bioinformatics 2003;00: 6.5.1– 6.5.6 [CrossRef]
    [Google Scholar]
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