TY - JOUR
T1 - Molecular epidemiology and risk factors of carbapenemase-producing Enterobacteriaceae isolates in Portuguese hospitals
T2 - Results From European survey on carbapenemase-producing Enterobacteriaceae (EuSCAPE)
AU - Manageiro, Vera
AU - Romão, Raquel
AU - Moura, Inês Barata
AU - Sampaio, Daniel A.
AU - Vieira, Luís
AU - Ferreira, Eugénia
AU - Caniça, Manuela
PY - 2018/11/27
Y1 - 2018/11/27
N2 - In Portugal, the epidemiological stage for the spread of carbapenemase-producing Enterobacteriaceae (CPE) increased from sporadic isolates or single hospital clones (2010–2013), to hospital outbreaks, later. Here we report data from a 6-month study performed under the European Survey on Carbapenemase-Producing Enterobacteriaceae (EuSCAPE). During the study period, 67 isolates (61 Klebsiella pneumoniae and 6 Escherichia coli) non-susceptible to carbapenems were identified in participant hospital laboratories. We detected 37 blaKPC–type (including one new variant: blaKPC–21), 1 blaGES–5, and 1 blaGES–6 plus blaKPC–3, alone or in combination with other bla genes. Bioinformatics analysis of the KPC-21-producing E. coli identified the new variant blaKPC–21 in a 12,748 bp length plasmid. The blaKPC–21 gene was harbored on a non-Tn4401 element, presenting upstream a partial ISKpn6 (ΔISKpn6/ΔtraN) with the related left IR (IRL) and downstream a truncated Tn3 transposon. PFGE and MLST analysis showed an important diversity, as isolates belonged to distinct PFGE and STs profiles. In this study, we highlighted the presence of the high-risk clone E. coli sequence-type (ST) 131 clade C/H30. This worldwide disseminated E. coli lineage was already detected in Portugal among other antibiotic resistance reservoirs. This study highlights the intra- and inter-hospital spread and possible intercontinental circulation of CPE isolates.
AB - In Portugal, the epidemiological stage for the spread of carbapenemase-producing Enterobacteriaceae (CPE) increased from sporadic isolates or single hospital clones (2010–2013), to hospital outbreaks, later. Here we report data from a 6-month study performed under the European Survey on Carbapenemase-Producing Enterobacteriaceae (EuSCAPE). During the study period, 67 isolates (61 Klebsiella pneumoniae and 6 Escherichia coli) non-susceptible to carbapenems were identified in participant hospital laboratories. We detected 37 blaKPC–type (including one new variant: blaKPC–21), 1 blaGES–5, and 1 blaGES–6 plus blaKPC–3, alone or in combination with other bla genes. Bioinformatics analysis of the KPC-21-producing E. coli identified the new variant blaKPC–21 in a 12,748 bp length plasmid. The blaKPC–21 gene was harbored on a non-Tn4401 element, presenting upstream a partial ISKpn6 (ΔISKpn6/ΔtraN) with the related left IR (IRL) and downstream a truncated Tn3 transposon. PFGE and MLST analysis showed an important diversity, as isolates belonged to distinct PFGE and STs profiles. In this study, we highlighted the presence of the high-risk clone E. coli sequence-type (ST) 131 clade C/H30. This worldwide disseminated E. coli lineage was already detected in Portugal among other antibiotic resistance reservoirs. This study highlights the intra- and inter-hospital spread and possible intercontinental circulation of CPE isolates.
KW - Carbapenemase-producing Enterobacteriaceae
KW - Escherichia coli
KW - EuSCAPE
KW - Klebsiella pneumoniae
KW - KPC-21
KW - Portugal
UR - http://www.scopus.com/inward/record.url?scp=85057744733&partnerID=8YFLogxK
U2 - 10.3389/fmicb.2018.02834
DO - 10.3389/fmicb.2018.02834
M3 - Article
AN - SCOPUS:85057744733
SN - 1664-302X
VL - 9
JO - Frontiers in Microbiology
JF - Frontiers in Microbiology
IS - NOV
M1 - 2834
ER -