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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2020-01-01
2021-10-16
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