Daniel Romero-Alvarez1, Jorge Reyes2, Viviana Quezada3, Carolina Satán4, Nelson Cevallos3, Sofía Barrera5, Gabriel Trueba5, Luis E Escobar6, José E Villacís7. 1. Hospital General Enrique Garcés, Quito, Ecuador; Department of Ecology and Evolutionary Biology, University of Kansas, Lawrence, KS, USA. Electronic address: da.romero@ku.edu. 2. Instituto Nacional de Investigación en Salud Pública (INSPI) "Dr. Leopoldo Izquieta Pérez," Quito, Ecuador; Universidad San Francisco de Quito, Quito, Ecuador; Universidad Central del Ecuador, Quito, Ecuador; Hospital Carlos Andrade Marín, Quito, Ecuador. 3. Hospital General Enrique Garcés, Quito, Ecuador. 4. Instituto Nacional de Investigación en Salud Pública (INSPI) "Dr. Leopoldo Izquieta Pérez," Quito, Ecuador. 5. Universidad San Francisco de Quito, Quito, Ecuador. 6. Department of Fish and Wildlife Conservation, Virginia Tech, Blacksburg, VA, USA. 7. Instituto Nacional de Investigación en Salud Pública (INSPI) "Dr. Leopoldo Izquieta Pérez," Quito, Ecuador; Pontificia Universidad Católica del Ecuador, Quito, Ecuador.
Abstract
OBJECTIVES: To describe a clinical case of Klebsiella pneumoniae harboring a New Delhi metallo-β-lactamase (NDM) plasmid in Ecuador and to present a map of reports of NDM isolates in South America. METHODS: The modified Hodge test, carbapenem inactivation method, imipenem-EDTA disk method (synergy), and Rapidec Carba NP test were used to identify antibiotic resistance mechanisms. The presence of resistance genes was explored with a conjugation assay, and molecular confirmation of NDM was performed by PCR and DNA sequencing. Plasmid characterization was conducted by PCR-based replicon typing. A literature review was performed in Google Scholar and PubMed to identify reports from South America. RESULTS: An HIV-infected patient, who had never traveled abroad, developed a bloodstream infection caused by K. pneumoniae ST147 harboring the NDM-1 resistance gene in a plasmid from the IncA/C group. Local circulation of NDM has also been described in other South American countries, in particular in Colombia and Brazil, although published scientific records were not found for other countries. CONCLUSIONS: This report presents the first evidence of autochthonous circulation of the NDM-1 resistance gene harbored by an IncA/C plasmid isolated from a K. pneumoniae ST147 in Ecuador. Efforts should be implemented to monitor and characterize the spatial and temporal distribution of NDM in Ecuador and other countries of South America.
OBJECTIVES: To describe a clinical case of Klebsiella pneumoniae harboring a New Delhi metallo-β-lactamase (NDM) plasmid in Ecuador and to present a map of reports of NDM isolates in South America. METHODS: The modified Hodge test, carbapenem inactivation method, imipenem-EDTA disk method (synergy), and Rapidec Carba NP test were used to identify antibiotic resistance mechanisms. The presence of resistance genes was explored with a conjugation assay, and molecular confirmation of NDM was performed by PCR and DNA sequencing. Plasmid characterization was conducted by PCR-based replicon typing. A literature review was performed in Google Scholar and PubMed to identify reports from South America. RESULTS: An HIV-infectedpatient, who had never traveled abroad, developed a bloodstream infection caused by K. pneumoniae ST147 harboring the NDM-1 resistance gene in a plasmid from the IncA/C group. Local circulation of NDM has also been described in other South American countries, in particular in Colombia and Brazil, although published scientific records were not found for other countries. CONCLUSIONS: This report presents the first evidence of autochthonous circulation of the NDM-1 resistance gene harbored by an IncA/C plasmid isolated from a K. pneumoniae ST147 in Ecuador. Efforts should be implemented to monitor and characterize the spatial and temporal distribution of NDM in Ecuador and other countries of South America.
Authors: Jesus Tamariz; Carlos Llanos; Carlos Seas; Paola Montenegro; Jose Lagos; Miriam R Fernandes; Louise Cerdeira; Nilton Lincopan Journal: Genome Announc Date: 2018-03-29