Anaëlle Muggeo1, Thomas Guillard2, Frédéric Klein1, Fany Reffuveille3, Caroline François4, Anamaria Babosan5, Odile Bajolet1, Xavier Bertrand6, Christophe de Champs1. 1. CHU Reims, Hôpital Robert Debré, Laboratoire de Bactériologie-Virologie-Hygiène, 51092 Reims, France; UFR Médecine, SFR CAP-Santé, EA 4687, Université de Reims Champagne-Ardenne, 51092 Reims, France. 2. CHU Reims, Hôpital Robert Debré, Laboratoire de Bactériologie-Virologie-Hygiène, 51092 Reims, France; UFR Médecine, SFR CAP-Santé, EA 4687, Université de Reims Champagne-Ardenne, 51092 Reims, France. Electronic address: tguillard@chu-reims.fr. 3. UFR Pharmacie, SFR CAP-Santé, EA 4691 BIOS, Université de Reims Champagne-Ardenne, 51092 Reims, France. 4. CHU de Reims, American Memorial Hospital, Service de Chirurgie Pédiatrique, 51092 Reims, France. 5. UFR Médecine, SFR CAP-Santé, EA 4687, Université de Reims Champagne-Ardenne, 51092 Reims, France. 6. CHRU Besançon, Service d'Hygiène Hospitalière, 25030 Besançon, France; UMR 6249 Chrono-environnement, Université de Bourgogne-Franche-Comté, 25030 Besançon, France.
Abstract
OBJECTIVES: Fluoroquinolones (FQs) are a potential treatment for infections caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae that are susceptible to these agents. METHODS: Owing to increasing non-susceptibility to carbapenems among Enterobacteriaceae, in this study FQ resistance mechanisms were characterised in 36 ertapenem-non-susceptible Klebsiella pneumoniae isolated from North-Eastern France in 2012. The population structure was described by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). RESULTS: Among the 36 isolates, 13 (36%) carried a carbapenemase encoding-gene. Decreased expression of the OmpK35-encoding gene might be considered a major resistance determinant that could explain the non-susceptibility to carbapenems. The carbapenemase-producing isolates carried the well-known IncL pOXA-48a plasmid. All 36 K. pneumoniae isolates also harboured a FQ resistance determinant. The aac(6')-Ib-cr gene was the major plasmid-mediated quinolone resistance (PMQR) determinant found in K. pneumoniae (89%; 32/36). MLST identified five sequence types (STs), with the most common being ST395 (69%; 25/36), followed by ST147 (17%; 6/36). ST395 strains showed ertapenem minimum inhibitory concentrations (MICs) ranging from 0.75-32μg/mL. Klebsiella pneumoniae ST395 isolates did not show enhanced biofilm formation or environmental survival but showed higher chlorhexidine MICs compared with ST147 isolates. CONCLUSIONS: These findings showed that (i) K. pneumoniae ST395 carrying pOXA-48a has spread in North-Eastern France, (ii) aac(6')-Ib-cr is predominant in carbapenem-non-susceptible K. pneumoniae, (iii) K. pneumoniae ST395 is resistant to chlorhexidine and (iv) FQs as an alternative to β-lactams to treat ertapenem-non-susceptible K. pneumoniae are compromised.
OBJECTIVES:Fluoroquinolones (FQs) are a potential treatment for infections caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae that are susceptible to these agents. METHODS: Owing to increasing non-susceptibility to carbapenems among Enterobacteriaceae, in this study FQ resistance mechanisms were characterised in 36 ertapenem-non-susceptible Klebsiella pneumoniae isolated from North-Eastern France in 2012. The population structure was described by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). RESULTS: Among the 36 isolates, 13 (36%) carried a carbapenemase encoding-gene. Decreased expression of the OmpK35-encoding gene might be considered a major resistance determinant that could explain the non-susceptibility to carbapenems. The carbapenemase-producing isolates carried the well-known IncL pOXA-48a plasmid. All 36 K. pneumoniae isolates also harboured a FQ resistance determinant. The aac(6')-Ib-cr gene was the major plasmid-mediated quinolone resistance (PMQR) determinant found in K. pneumoniae (89%; 32/36). MLST identified five sequence types (STs), with the most common being ST395 (69%; 25/36), followed by ST147 (17%; 6/36). ST395 strains showed ertapenem minimum inhibitory concentrations (MICs) ranging from 0.75-32μg/mL. Klebsiella pneumoniae ST395 isolates did not show enhanced biofilm formation or environmental survival but showed higher chlorhexidine MICs compared with ST147 isolates. CONCLUSIONS: These findings showed that (i) K. pneumoniae ST395 carrying pOXA-48a has spread in North-Eastern France, (ii) aac(6')-Ib-cr is predominant in carbapenem-non-susceptible K. pneumoniae, (iii) K. pneumoniae ST395 is resistant to chlorhexidine and (iv) FQs as an alternative to β-lactams to treat ertapenem-non-susceptible K. pneumoniae are compromised.
Authors: Fang Kang Lim; Yi Xin Liew; Yiying Cai; Winnie Lee; Jocelyn Q M Teo; Wei Qi Lay; Jasmine Chung; Andrea L H Kwa Journal: Front Cell Infect Microbiol Date: 2020-10-14 Impact factor: 5.293
Authors: Teresa Fasciana; Andrea Ciammaruconi; Bernardina Gentile; Paola Di Carlo; Roberta Virruso; Maria Rita Tricoli; Daniela Maria Palma; Giovanna Laura Pitarresi; Florigio Lista; Anna Giammanco Journal: Antibiotics (Basel) Date: 2021-05-11