This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Open AccessArticle
Plasmid-Mediated Spread of Carbapenem Resistance in Enterobacterales: A Three-Year Genome-Based Survey
by
Yancheng Yao
Yancheng Yao 1,2,*,†
,
Can Imirzalioglu
Can Imirzalioglu 1,2
,
Linda Falgenhauer
Linda Falgenhauer 1,3,4,
Jane Falgenhauer
Jane Falgenhauer 1,2,3
,
Petra Heinmüller
Petra Heinmüller 4,‡
on behalf of the SurvCARE Hesse Working Group,
Eugen Domann
Eugen Domann 1,2,3,*,†
and
Trinad Chakraborty
Trinad Chakraborty 1,2
1
Institute of Medical Microbiology, Justus Liebig University Giessen, Schubertstrasse 81, 35392 Giessen, Germany
2
German Center for Infection Research (DZIF), Partner Site Giessen-Marburg-Langen, 35392 Giessen, Germany
3
Institute for Hygiene and Environmental Medicine, Justus Liebig University Giessen, Schubertstrasse 81, 35392 Giessen, Germany
4
Hessisches Landesamt für Gesundheit und Pflege (HLfGP), Heinrich-Hertz-Strasse 5, 35683 Dillenburg, Germany
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
‡
Members of the SurvCARE Hesse Working Group are listed in the Acknowledgements section.
Antibiotics 2024, 13(8), 682; https://doi.org/10.3390/antibiotics13080682 (registering DOI)
Submission received: 19 June 2024
/
Revised: 19 July 2024
/
Accepted: 19 July 2024
/
Published: 23 July 2024
Abstract
The worldwide emergence and dissemination of carbapenem-resistant Gram-negative bacteria (CRGNB) is a challenging problem of antimicrobial resistance today. Outbreaks with CRGNB have severe consequences for both the affected healthcare settings as well as the patients with infection. Thus, bloodstream infections caused by metallo-ß-lactamase-producing Enterobacterales can often have clinical implications, resulting in high mortality rates due to delays in administering effective treatment and the limited availability of treatment options. The overall threat of CRGNB is substantial because carbapenems are used to treat infections caused by ESBL-producing Enterobacterales which also exist with high frequency within the same geographical regions. A genome-based surveillance of 589 CRGNB from 61 hospitals across the federal state Hesse in Germany was implemented using next-generation sequencing (NGS) technology to obtain a high-resolution landscape of carbapenem-resistant isolates over a three-year period (2017–2019). The study examined all reportable CRGNB isolates submitted by participating hospitals. This included isolates carrying known carbapenemases (435) together with carbapenem-resistant non-carbapenemase producers (154). Predominant carbapenemase producers included Klebsiella pneumoniae, Escherichia coli, Citrobacter freundii and Acinetobacter baumannii. Over 80% of 375 carbapenem-resistant determinants including KPC-, NDM-, VIM- and OXA-48-like ones detected in 520 Enterobacterales were plasmid-encoded, and half of these were dominated by a few incompatibility (Inc) types, viz., IncN, IncL/M, IncFII and IncF(K). Our results revealed that plasmids play an extraordinary role in the dissemination of carbapenem resistance in the heterogeneous CRGNB population. The plasmids were also associated with several multispecies dissemination events and local outbreaks throughout the study period, indicating the substantial role of horizontal gene transfer in carbapenemase spread. Furthermore, due to vertical and horizontal plasmid transfer, this can have an impact on implant-associated infections and is therefore important for antibiotic-loaded bone cement and drug-containing devices in orthopedic surgery. Future genomic surveillance projects should increase their focus on plasmid characterization.
Share and Cite
MDPI and ACS Style
Yao, Y.; Imirzalioglu, C.; Falgenhauer, L.; Falgenhauer, J.; Heinmüller, P., on behalf of the SurvCARE Hesse Working Group; Domann, E.; Chakraborty, T.
Plasmid-Mediated Spread of Carbapenem Resistance in Enterobacterales: A Three-Year Genome-Based Survey. Antibiotics 2024, 13, 682.
https://doi.org/10.3390/antibiotics13080682
AMA Style
Yao Y, Imirzalioglu C, Falgenhauer L, Falgenhauer J, Heinmüller P on behalf of the SurvCARE Hesse Working Group, Domann E, Chakraborty T.
Plasmid-Mediated Spread of Carbapenem Resistance in Enterobacterales: A Three-Year Genome-Based Survey. Antibiotics. 2024; 13(8):682.
https://doi.org/10.3390/antibiotics13080682
Chicago/Turabian Style
Yao, Yancheng, Can Imirzalioglu, Linda Falgenhauer, Jane Falgenhauer, Petra Heinmüller on behalf of the SurvCARE Hesse Working Group, Eugen Domann, and Trinad Chakraborty.
2024. "Plasmid-Mediated Spread of Carbapenem Resistance in Enterobacterales: A Three-Year Genome-Based Survey" Antibiotics 13, no. 8: 682.
https://doi.org/10.3390/antibiotics13080682
Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details
here.
Article Metrics
Article metric data becomes available approximately 24 hours after publication online.