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Genomic Characterization of VIM and MCR Co-Producers: The First Two Clinical Cases, in Italy

VM. Marchetti, I. Bitar, M. Sarti, E. Fogato, E. Scaltriti, C. Bracchi, J. Hrabak, S. Pongolini, R. Migliavacca

. 2021 ; 11 (1) : . [pub] 20210106

Jazyk angličtina Země Švýcarsko

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc21010730

Grantová podpora
NU20J-05-00033 Czech Health Research Council
CZ.02.1.01/0.0/0.0/16_019/0000787 Ministry of Education Youth and Sports of the Czech Republic.

BACKGROUND: the co-production of carbapenemases and mcr-genes represents a worrisome event in the treatment of Enterobacteriaceae infections. The aim of the study was to characterize the genomic features of two clinical Enterobacter cloacae complex (ECC) isolates, co-producing VIM and MCR enzymes, in Italy. METHODS: species identification and antibiotic susceptibility profiling were performed using MALDI-TOF and broth microdilution methods, respectively. Transferability of the blaVIM- and mcr- type genes was verified through conjugation experiment. Extracted DNA was sequenced using long reads sequencing technology on the Sequel I platform (PacBio). RESULTS: the first isolate showed clinical resistance against ertapenem yet was colistin susceptible (EUCAST 2020 breakpoints). The mcr-9.2 gene was harbored on a conjugative IncHI2 plasmid, while the blaVIM-1 determinant was harbored on a conjugative IncN plasmid. The second isolate, resistant to both carbapenems and colistin, harbored: mcr-9 gene and its two component regulatory genes for increased expression on the chromosome, mcr-4.3 on non-conjugative (yet co-transferable) ColE plasmid, and blaVIM-1 on a non-conjugative IncA plasmid. CONCLUSIONS: to our knowledge, this is the first report of co-production of VIM and MCR in ECC isolates in Italy.

Citace poskytuje Crossref.org

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$a BACKGROUND: the co-production of carbapenemases and mcr-genes represents a worrisome event in the treatment of Enterobacteriaceae infections. The aim of the study was to characterize the genomic features of two clinical Enterobacter cloacae complex (ECC) isolates, co-producing VIM and MCR enzymes, in Italy. METHODS: species identification and antibiotic susceptibility profiling were performed using MALDI-TOF and broth microdilution methods, respectively. Transferability of the blaVIM- and mcr- type genes was verified through conjugation experiment. Extracted DNA was sequenced using long reads sequencing technology on the Sequel I platform (PacBio). RESULTS: the first isolate showed clinical resistance against ertapenem yet was colistin susceptible (EUCAST 2020 breakpoints). The mcr-9.2 gene was harbored on a conjugative IncHI2 plasmid, while the blaVIM-1 determinant was harbored on a conjugative IncN plasmid. The second isolate, resistant to both carbapenems and colistin, harbored: mcr-9 gene and its two component regulatory genes for increased expression on the chromosome, mcr-4.3 on non-conjugative (yet co-transferable) ColE plasmid, and blaVIM-1 on a non-conjugative IncA plasmid. CONCLUSIONS: to our knowledge, this is the first report of co-production of VIM and MCR in ECC isolates in Italy.
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$a Bitar, Ibrahim $u Department of Microbiology, Faculty of Medicine and University Hospital in Pilsen, Charles University, 306 05 Pilsen, Czech Republic ; Biomedical Center, Faculty of Medicine, Charles University, 323 00 Pilsen, Czech Republic
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$a Sarti, Mario $u Clinical Microbiology, Azienda Ospedaliero-Universitaria di Modena, 411 25 Modena, Italy
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$a Fogato, Elena $u Laboratory of Clinical Microbiology, ASP "Golgi-Redaelli", 201 46 Milan, Italy
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$a Scaltriti, Erika $u Risk Analysis and Genomic Epidemiology Unit, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, 43126 Parma, Italy
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$a Bracchi, Chiara $u Risk Analysis and Genomic Epidemiology Unit, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, 43126 Parma, Italy
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$a Hrabak, Jaroslav $u Department of Microbiology, Faculty of Medicine and University Hospital in Pilsen, Charles University, 306 05 Pilsen, Czech Republic ; Biomedical Center, Faculty of Medicine, Charles University, 323 00 Pilsen, Czech Republic
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$a Pongolini, Stefano $u Risk Analysis and Genomic Epidemiology Unit, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia-Romagna, 43126 Parma, Italy
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$a Migliavacca, Roberta $u Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Unit of Microbiology and Clinical Microbiology, University of Pavia, 27100 Pavia, Italy
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