Journal
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
Volume 59, Issue 1, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.ijantimicag.2021.106456
Keywords
Aminoglycosides; Methyltransferases; Carbapenemases; Enterobacterales; Spain
Funding
- Ministerio de Economia y Competitividad of Spain, Instituto de Salud Carlos III [PI15/00860, PI18/00501, P17/01482]
- MEIC through the Instituto de Salud Carlos III
- 2014-2020 Smart Growth Operating Program
- European Regional Development Fund [MINECO/FEDER] [BIO2015-71792-P]
- Centro de Excelencia Severo Ochoa
- Generalitat de Catalunya through the Departament de Salut, Departament d'Empresa i Coneixement
- CERCA Programme
- Planes Nacionales de I+ D+ i 2013-2016
- ISCIII
- Subdirecion General de Redes y Centros de Investigacion Cooperativa
- Ministerio de Economia y Competitividad, Spanish Network for Research in Infectious Diseases - European Regional Development Fund 'A Way to Achieve Europe' [REIPI RD16/0016/006]
- operative Intelligent Growth program 2014-2020
- Fundacion Profesor Novoa Santos
- Rio Hortega program [ISCIII-SERGAS] [CM19/00219]
- Juan Rodes program [ISCIII-SERGAS] [JR18/000 06]
- pFIS program [ISCIII] [PI17/01482]
Ask authors/readers for more resources
This study investigated the prevalence, resistance mechanisms, molecular epidemiology, and genetic support of 16S rRNA methyltransferases (RMTs) in carbapenemase-producing Enterobacterales (CPE) isolates from Spain. The findings show an emerging trend of RMTs among clinical CPE isolates, posing a threat to the clinical utility of aminoglycosides and plazomicin.
The emergence of 16S rRNA methyltransferases (RMTs) in Gram-negative pathogens bearing other clinically relevant resistance mechanisms, such as carbapenemase-producing Enterobacterales (CPE), is becoming an alarming concern. We investigated the prevalence, antimicrobial susceptibility, resistance mechanisms, molecular epidemiology and genetic support of RMTs in CPE isolates from Spain. This study included a collection of 468 CPE isolates recovered during 2018 from 32 participating Spanish hospitals. MICs were determined using the broth microdilution method, the agar dilution method (fosfomycin) or MIC gradient strips (plazomicin). All isolates were subjected to hybrid whole-genome sequencing (WGS). Sequence types (STs), core genome phylogenetic relatedness, horizontally acquired resistance mechanisms, plasmid analysis and the genetic environment of RMTs were determined in silico from WGS data in all RMT-positive isolates. Among the 468 CPE isolates evaluated, 24 isolates (5.1%) recovered from nine different hospitals spanning five Spanish regions showed resistance to all aminoglycosides and were positive for an RMT (21 RmtF, 2 ArmA and 1 RmtC). All RMT-producers showed high-level resistance to all aminoglycosides, including plazomicin, and in most cases exhibited an extensively drug-resistant susceptibility profile. The RMT-positive isolates showed low genetic diversity and were global clones of Klebsiella pneumoniae (ST147, ST101, ST395) and Enterobacter cloacae (ST93) bearing bla OXA-48, bla NDM-1 or bla VIM-1 carbapenemase genes. RMTs were harboured in five different multidrug resistance plasmids and linked to efficient mobile genetic elements. Our findings highlight that RMTs are emerging among clinical CPE isolates from Spain and their spread should be monitored to preserve the future clinical utility of aminoglycosides and plazomicin. (C) 2021 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available