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Antibiotics
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Carbapenem-Resistant Enterobacterales
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Carbapenem-Resistant Enterobacterales

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Mechanism and Evolution of Antibiotic Resistance".

Deadline for manuscript submissions: closed (15 September 2022) | Viewed by 7911

Special Issue Editors

Dr. Marta Hernández-García

E-Mail
Guest Editor
Hospital Universitario Ramón y Cajal, IRYCYS, Madrid, Spain
Interests: antibiotic resistance; Klebsiella pneumoniae; Escherichia coli; Pseudomonas aeruginosa; epidemiology surveillance studies; novel β-lactam-β-lactamase inhibitor combinations; whole genome sequencing
Dr. Rosa Del Campo

E-Mail Website
Guest Editor
Hospital Universitario Ramón y Cajal, IRYCYS, Madrid, Spain
Interests: gut microbiome; antimicrobial resistance; cystic fibrosis; metagenomic analysis

Special Issue Information

Dear Colleagues,

Carbapenem-resistant Enterobacterales isolates have become an increasing threat to public health worldwide due to the limited therapeutic options for their treatment and the high rate of associated morbidity and mortality. Carbapenem resistance is usually mediated by the production of transferable carbapenemase enzymes, frequently combined with other resistance mechanisms, such as efflux pumps, enzymatic degradation, porin mutations, and target–site alterations. Carbapenemase enzymes are classified into different molecular classes: class A (e.g., KPC and GES), class B (or metallo-β-lactamases (MBLs)) (e.g., VIM, IMP and NDM), and class D (or oxacillinases (OXA-type)). Carbapenemases are often contained on mobile genetic platforms, such as plasmids and transposons, that frequently harbor resistance determinants to other antibiotic groups, contributing to the emergence of multidrug-resistant pathogens. Carbapenemase production is normally linked to successful multidrug-resistant clones, particularly K. pneumoniae high-risk clones, commonly associated with healthcare related infections and with a high capacity of persistence in hospital settings.

Therefore, the main subject of this Special Issue includes any approach to characterizing the epidemiology, antibiotic susceptibility profiles, and resistance mechanisms involved in carbapenem resistant Enterobacterales isolates, as well as any study focused on improving the implementation of infection control measures targeted towards reducing the prevalence of these multidrug-resistant Gram-negative bacteria and to developing safe alternative treatment options.

Dr. Marta Hernández-García
Dr. Rosa Del Campo
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Carbapenemase-producing Enterobacterales
  • Plasmids
  • Co-resistance
  • Nosocomial infections
  • K. pneumoniae high-risk clones
  • Infection control measures

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Published Papers (3 papers)

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Research

18 pages, 2159 KiB  
Article
Carbapenemase-Producing Klebsiella pneumoniae in COVID-19 Intensive Care Patients: Identification of IncL-VIM-1 Plasmid in Previously Non-Predominant Sequence Types
by Javier E. Cañada-García, Eva Ramírez de Arellano, Miguel Jiménez-Orellana, Esther Viedma, Aida Sánchez, Almudena Alhambra, Jennifer Villa, Alberto Delgado-Iribarren, Verónica Bautista, Noelia Lara, Silvia García-Cobos, Belén Aracil, Emilia Cercenado, María Pérez-Vázquez and Jesús Oteo-Iglesias
Antibiotics 2023, 12(1), 107; https://doi.org/10.3390/antibiotics12010107 - 6 Jan 2023
Cited by 4 | Viewed by 2871
Abstract
During the COVID-19 pandemic, intensive care units (ICUs) operated at or above capacity, and the number of ICU patients coinfected by nosocomial microorganisms increased. Here, we characterize the population structure and resistance mechanisms of carbapenemase-producing Klebsiella pneumoniae (CP-Kpn) from COVID-19 ICU patients and [...] Read more.
During the COVID-19 pandemic, intensive care units (ICUs) operated at or above capacity, and the number of ICU patients coinfected by nosocomial microorganisms increased. Here, we characterize the population structure and resistance mechanisms of carbapenemase-producing Klebsiella pneumoniae (CP-Kpn) from COVID-19 ICU patients and compare them to pre-pandemic populations of CP-Kpn. We analyzed 84 CP-Kpn isolates obtained during the pandemic and 74 CP-Kpn isolates obtained during the pre-pandemic period (2019) by whole genome sequencing, core genome multilocus sequence typing, plasmid reconstruction, and antibiotic susceptibility tests. More CP-Kpn COVID-19 isolates produced OXA-48 (60/84, 71.4%) and VIM-1 (18/84, 21.4%) than KPC (8/84, 9.5%). Fewer pre-pandemic CP-Kpn isolates produced VIM-1 (7/74, 9.5%). Cefiderocol (97.3–100%) and plazomicin (97.5–100%) had the highest antibiotic activity against pandemic and pre-pandemic isolates. Sequence type 307 (ST307) was the most widely distributed ST in both groups. VIM-1-producing isolates belonging to ST307, ST17, ST321 and ST485, (STs infrequently associated to VIM-1) were detected during the COVID-19 period. Class 1 integron Int1-blaVIM-1-aac(6′)-1b-dfrB1-aadAI-catB2-qacEΔ1/sul1, found on an IncL plasmid of approximately 70,000 bp, carried blaVIM-1 in ST307, ST17, ST485, and ST321 isolates. Thus, CP-Kpn populations from pandemic and pre-pandemic periods have similarities. However, VIM-1 isolates associated with atypical STs increased during the pandemic, which warrants additional monitoring and surveillance. Full article
(This article belongs to the Special Issue Carbapenem-Resistant Enterobacterales)
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9 pages, 1273 KiB  
Communication
Genomic Diversity of NDM-Producing Klebsiella Species from Brazil, 2013–2022
by Carlos Henrique Camargo, Amanda Yaeko Yamada, Andreia Rodrigues de Souza, Alex Domingos Reis, Marlon Benedito Nascimento Santos, Denise Brandão de Assis, Eneas de Carvalho, Elizabeth Harummyy Takagi, Marcos Paulo Vieira Cunha and Monique Ribeiro Tiba-Casas
Antibiotics 2022, 11(10), 1395; https://doi.org/10.3390/antibiotics11101395 - 12 Oct 2022
Cited by 9 | Viewed by 1829
Abstract
Background: Since its first report in the country in 2013, NDM-producing Enterobacterales have been identified in all the Brazilian administrative regions. In this study, we characterized by antimicrobial susceptibility testing and by molecular typing a large collection of NDM-producing Klebsiella isolates from different [...] Read more.
Background: Since its first report in the country in 2013, NDM-producing Enterobacterales have been identified in all the Brazilian administrative regions. In this study, we characterized by antimicrobial susceptibility testing and by molecular typing a large collection of NDM-producing Klebsiella isolates from different hospitals in Brazil, mainly from the state of Sao Paulo, over the last decade. Methods: Bacterial isolates positive for blaNDM-genes were identified by MALDI-TOF MS and submitted to antimicrobial susceptibility testing by disk diffusion or broth microdilution (for polymyxin B). All isolates were submitted to pulsed-field gel electrophoresis, and isolates belonging to different clusters were submitted to whole genome sequencing by Illumina technology and downstream analysis. Mating out assays were performed by conjugation, plasmid sizes were determined by S1-PFGE, and plasmid content was investigated by hybrid assembly after MinIon long reads sequencing. Results: A total of 135 NDM-producing Klebsiella were identified, distributed into 107 different pulsotypes; polymyxin B was the only antimicrobial with high activity against 88.9% of the isolates. Fifty-four isolates presenting diversified pulsotypes were distributed in the species K. pneumoniae (70%), K. quasipneumoniae (20%), K. variicola (6%), K. michiganensis (a K. oxytoca Complex species, 2%), and K. aerogenes (2%); blaNDM-1 was the most frequent allele (43/54, 80%). There was a predominance of Clonal Group 258 (ST11 and ST340) encompassing 35% of K. pneumoniae isolates, but another thirty-one different sequence types (ST) were identified, including three described in this study (ST6244 and ST6245 for K. pneumoniae, and ST418 for K. michiganensis). The blaNDM-1 and blaNDM-7 were found to be located into IncF and IncX3 type transferable plasmids, respectively. Conclusions: Both clonal (mainly driven by CG258) and non-clonal expansion of NDM-producing Klebsiella have been occurring in Brazil in different species and clones, associated with different plasmids, since 2013. Full article
(This article belongs to the Special Issue Carbapenem-Resistant Enterobacterales)
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8 pages, 696 KiB  
Communication
Multicenter Study of Carbapenemase-Producing Enterobacterales in Havana, Cuba, 2016–2021
by Haiyang Yu, María Karla González Molina, Yenisel Carmona Cartaya, Marcia Hart Casares, Meiji Soe Aung, Nobumichi Kobayashi and Dianelys Quiñones Pérez
Antibiotics 2022, 11(4), 514; https://doi.org/10.3390/antibiotics11040514 - 12 Apr 2022
Cited by 5 | Viewed by 2304
Abstract
Surveillance of carbapenem resistance is particularly important for Enterobacterales, mainly in countries with limited healthcare resources. We conducted a cross-sectional study to detect carbapenem-resistant Enterobacterales at 10 sentinel hospitals in Havana, Cuba for a six year-period (2016–2021) by the National Reference Laboratory for [...] Read more.
Surveillance of carbapenem resistance is particularly important for Enterobacterales, mainly in countries with limited healthcare resources. We conducted a cross-sectional study to detect carbapenem-resistant Enterobacterales at 10 sentinel hospitals in Havana, Cuba for a six year-period (2016–2021) by the National Reference Laboratory for Health Care-Associated Infections in the Pedro Kourí Institute. A total of 152 isolates were collected with phenotypic production of metallo-β-lactamase. NDM-type carbapenemase was detected in all the 152 isolates, and KPC-type enzyme gene was simultaneously identified in four NDM-positive isolates. The most abundant carbapenemase-producing Enterobacterales (CPE) species was Klebsiella pneumoniae (69.7%), followed by Enterobacter cloacae complex (13.2%), and Escherichia coli (5.9%). Over the study period, among CPE, prevalence of K. pneumoniae was almost constant, while Enterobacter spp. showed slightly increasing tendency. The urinary tract (36.2%) was the most prevalent source of infection with CPE, followed by bloodstream (26.3%) and surgical wound (17.1%), being frequently derived from Intensive Care Units (35.5%) and urology wards (21.7%). This study revealed the present situation of CPE in hospitals in Havana, Cuba, showing the emergence and dissemination of Enterobacterales producing NDM-type carbapenemase, mainly K. pneumoniae. Full article
(This article belongs to the Special Issue Carbapenem-Resistant Enterobacterales)
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