This report presents phenotypic and genetic data on the prevalence and characteristics of extended-spectrum β-lactamases (ESBLs) and representative carbapenemases-producing Gram-negative species in ...Mexico.
A total of 52 centers participated, 43 hospital-based laboratories and 9 external laboratories. The distribution of antimicrobial resistance data for Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, Acinetobacter baumannii complex, and Pseudomonas aeruginosa in selected clinical specimens from January 1 to March 31, 2020 was analyzed using the WHONET 5.6 platform. The following clinical isolates recovered from selected specimens were included: carbapenem-resistant Enterobacteriaceae, ESBL or carbapenem-resistant E. coli, and K. pneumoniae, carbapenem-resistant A. baumannii complex, and P. aeruginosa. Strains were genotyped to detect ESBL and/or carbapenemase-encoding genes.
Among blood isolates, A. baumannii complex showed more than 68% resistance for all antibiotics tested, and among Enterobacteria, E. cloacae complex showed higher resistance to carbapenems. A. baumannii complex showed a higher resistance pattern for respiratory specimens, with only amikacin having a resistance lower than 70%. Among K. pneumoniae isolates, blaTEM, blaSHV, and blaCTX were detected in 68.79%, 72.3%, and 91.9% of isolates, respectively. Among E. coli isolates, blaTEM, blaSHV, and blaCTX were detected in 20.8%, 4.53%, and 85.7% isolates, respectively. For both species, the most frequent genotype was blaCTX-M-15. Among Enterobacteriaceae, the most frequently detected carbapenemase-encoding gene was blaNDM-1 (81.5%), followed by blaOXA-232 (14.8%) and blaoxa-181(7.4%), in A. baumannii was blaOXA-24 (76%) and in P. aeruginosa, was blaIMP (25.3%), followed by blaGES and blaVIM (13.1% each).
Our study reports that NDM-1 is the most frequent carbapenemase-encoding gene in Mexico in Enterobacteriaceae with the circulation of the oxacillinase genes 181 and 232. KPC, in contrast to other countries in Latin America and the USA, is a rare occurrence. Additionally, a high circulation of ESBL blaCTX-M-15 exists in both E. coli and K. pneumoniae.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
expressing serotype 3 has a high virulence and a high case fatality ratio. Most studies of serotype 3 pneumococci have focused on a single lineage, the widespread sequence type 180 (ST180). To ...evaluate the serotype 3 lineages causing infections in Mexico, we characterized 196 isolates recovered from 1994 to 2017. The isolates were mostly susceptible to all antimicrobials tested. A single meningitis isolate was resistant to penicillin, and the resistance to erythromycin was 5.2%. The isolates represented the widely disseminated clonal complex 180 (CC180;
= 140), the unusual CC4909 (
= 42), CC260 (
= 11), and a few singletons (
= 3). CC260 was less frequent among pneumococcal invasive disease isolates than CC180 and CC4909 (
= 0.015). There was a decrease of CC4909 (
< 0.001) following PCV13 introduction (2012 to 2017). The CC4909 isolates were represented mostly by ST1119 (
= 40), seemingly having a restricted geographic origin, with isolates in the PubMLST database having been recovered only in Mexico, the United States, and Germany. A genomic analysis of publicly available genomes showed that ST1119 isolates have less than 32% similarity with ST180 isolates, indicating that these lineages are more separated than revealed by traditional multilocus sequence typing. Considering the suggestions of a lower efficacy of the 13-valent pneumococcal conjugate vaccine against serotype 3, the different dynamics of the two major serotype 3 lineages in Mexico following the introduction of PCV13 should be closely monitored.
In this study, we report the carbapenemase-encoding genes and colistin resistance in
,
,
, and
in the second year of the COVID-19 pandemic. Clinical isolates included carbapenem-resistant
, ...carbapenem-resistant
, carbapenem-resistant
, and carbapenem-resistant
. Carbapenemase-encoding genes were detected by PCR. Carbapenem-resistant
and carbapenem-resistant
isolates were analyzed using the Rapid Polymyxin NP assay.
genes were screened by PCR. Pulsed-field gel electrophoresis and whole-genome sequencing were performed on representative isolates. A total of 80 carbapenem-resistant
, 103 carbapenem-resistant
, 284 carbapenem-resistant
, and 129 carbapenem-resistant
isolates were recovered. All carbapenem-resistant
and carbapenem-resistant
isolates were included for further analysis. A selection of carbapenem-resistant
and carbapenem-resistant
strains was further analyzed (86 carbapenem-resistant
and 82 carbapenem-resistant
). Among carbapenem-resistant
and carbapenem-resistant
isolates, the most frequent gene was
(86/103 83.5% and 72/80 90%, respectively). For carbapenem-resistant
, the most frequently detected gene was
(52/86, 60.5%), and for carbapenem-resistant
, was
(19/82, 23.2%). For carbapenem-resistant
, five indistinguishable pulsotypes were detected. Circulation of
New Delhi metallo-β-lactamase (NDM) and
NDM was detected in Mexico. High virulence sequence types (STs), such as
ST307,
ST167,
ST111, and
ST2, were detected. Among
isolates, 18/101 (17.8%) were positive for the Polymyxin NP test (two, 11.0% positive for the
gene, and one, 5.6% with disruption of the
gene). All
isolates were negative for the Polymyxin NP test. In conclusion,
NDM and
NDM were detected in Mexico, with the circulation of highly virulent STs. These results are relevant in clinical practice to guide antibiotic therapies considering the molecular mechanisms of resistance to carbapenems.
We analyzed the antimicrobial resistance (AMR) data of 6519 clinical isolates of Escherichia coli (n = 3985), Klebsiella pneumoniae (n = 775), Acinetobacter baumannii (n = 163), Pseudomonas ...aeruginosa (n = 781), Enterococcus faecium (n = 124), and Staphylococcus aureus (n = 691) from 43 centers in Mexico. AMR assays were performed using commercial microdilution systems (37/43) and the disk diffusion susceptibility method (6/43). The presence of carbapenemase-encoding genes was assessed using PCR. Data from centers regarding site of care, patient age, and clinical specimen were collected. According to the site of care, the highest AMR was observed in E. coli, K. pneumoniae, and P. aeruginosa isolates from ICU patients. In contrast, in A. baumannii, higher AMR was observed in isolates from hospitalized non-ICU patients. According to age group, the highest AMR was observed in the ≥60 years age group for E. coli, E. faecium, and S. aureus, and in the 19–59 years age group for A. baumannii and P. aeruginosa. According to clinical specimen type, a higher AMR was observed in E. coli, K. pneumoniae, and P. aeruginosa isolates from blood specimens. The most frequently detected carbapenemase-encoding gene in E. coli was blaNDM (84%).
•Genomic characteristics of carbapenem non-susceptible bacteria.•Molecular epidemiology of carbapenem non-susceptible bacteria.•The in silico analysis to compare bioinformatics platforms.•EPISEQ-CS ...provided a reliable method for virulome and resistome, plus MLST analysis.
To determine genomic characteristics and molecular epidemiology of carbapenem non-susceptible Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii, and Pseudomonas aeruginosa from medical centres of Mexico using whole genome sequencing data analysed with the EPISEQⓇ CS application and other bioinformatic platforms.
Clinical isolates collected from 28 centres in Mexico included carbapenem-non-susceptible K. pneumoniae (n = 22), E. coli (n = 24), A. baumannii (n = 16), and P. aeruginosa (n = 13). Isolates were subjected to whole genome sequencing using the Illumina (MiSeq) platform. FASTQ files were uploaded to the EPISEQⓇ CS application for analysis. Additionally, the tools Kleborate v2.0.4 and Pathogenwatch were used as comparators for Klebsiella genomes, and the bacterial whole genome sequence typing database was used for E. coli and A. baumannii.
For K. pneumoniae, both bioinformatic approaches detected multiple genes encoding aminoglycoside, quinolone, and phenicol resistance, and the presence of blaNDM-1 explained carbapenem non-susceptibility in 18 strains and blaKPC-3 in four strains. Regarding E. coli, both EPISEQⓇ CS and bacterial whole genome sequence typing database analyses detected multiple virulence and resistance genes: 20 of 24 (83.3%) strains carried blaNDM, 3 of 24 (12.4%) carried blaOXA-232, and 1 carried blaOXA-181. Genes that confer resistance to aminoglycosides, tetracyclines, sulfonamides, phenicols, trimethoprim, and macrolides were also detected by both platforms. Regarding A. baumannii, the most frequent carbapenemase-encoding gene detected by both platforms was blaOXA-72, followed by blaOXA-66. Both approaches detected similar genes for aminoglycosides, carbapenems, tetracyclines, phenicols, and sulfonamides. Regarding P. aeruginosa, blaVIM, blaIMP, and blaGES were the more frequently detected. Multiple virulence genes were detected in all strains.
Compared to the other available platforms, EPISEQⓇ CS enabled a comprehensive resistance and virulence analysis, providing a reliable method for bacterial strain typing and characterization of the virulome and resistome.
With the increasing prevalence of bloodstream infections caused by Candida sp. is necessary to establish the susceptibility of resistant strains in various geographical regions.
To determine the in ...vitro susceptibility to fluconazole, itraconazole, voriconazole and amphotericin B in yeasts isolated from blood through E test method.
In the period from 1992 to 2007, a total 112 strains of Candida species were isolated from blood of patients at the National Institute of Cardiology Ignacio Chavez. Susceptibility of these strains was performed to know the level of resistance to Itraconazole, Fluconazole, Voriconazole and Amphotericine B by E test method.
C. albicans was the most common species (60.2%), followed by C. tropicalis (9.8%). A five percent of resistance to itraconazole, 1.8% to fluconazole; and 0.9% to amphotericine B and voriconazole were found. C. glabrata was the most resistant species to the four antifungal agents.
The yeasts resistance to the four antifungal agents is still lower in our patients.
Highlights • We describe an annual decrease in the proportion of pneumococcal serotypes included in pneumococcal conjugate vaccines (PCV) causing invasive and non-invasive pneumococcal disease among ...people. • 5 years of age not targeted to receive the vaccine, after introduction of PCV in the universal vaccine program. • The strongest decrease of pneumococcal diseases was observed in the group of adults from 18 to 49 years of age. • A statistically significant increase of serotype 19A in all study groups was observed, except in adults ≥65 years. • A significant increase of non-vaccine pneumococcal serotypes was observed after the introduction of PCV: Serogroup 15 in the age group 50-64 years and serogroup 23 in children and adolescents among 5-17 years old.
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