AI Article Synopsis
- Carbapenems are critical antibiotics for treating multidrug-resistant Enterobacteriaceae, and this study focused on analyzing the plasmid content and resistance genes of these bacteria in Lebanon from 2016 to 2019.
- The research involved examining 65 clinical samples of carbapenem-resistant Enterobacteriaceae using plasmid typing and whole-genome sequencing, identifying various resistance genes and plasmid incompatibility groups.
- The findings highlighted the prevalence of specific carbapenemases like NDM variants and OXA-48, emphasizing the importance of monitoring these resistance determinants in healthcare environments to prevent their spread.
Article Abstract
Objectives: Carbapenems are among the few effective antibiotics against multidrug-resistant Enterobacteriaceae. This study aimed at characterizing the plasmid content and resistome of clinical carbapenem-resistant Enterobacteriaceae (CRE) recovered from 2016 to 2019 from hospitalized patients in Lebanon.
Methods: Plasmid typing and whole-genome sequencing were used to study the genomic characteristics of 65 clinical CREs including 27 Escherichia coli, 24 Klebsiella pneumoniae, one Klebsiella quasipneumoniae, three Morganella morganii, three Citrobacter freundii, five Enterobacter hormaechei, and two Serratia marcescens.
Results: bla (33.8%; n = 22) and bla-like genes were among the detected resistance determinants, with two isolates co-harbouring bla. Various bla variants, bla (16.9%; n = 11), bla (9.2%; n = 6), bla (9.2%; n = 6), and bla (4.6%; n = 3), different ESBLs, and AmpC β-lactamases were detected. Carbapenem resistance determinants were linked to a variety of incompatibility groups with IncFIB(K) (43.1%; n = 28) being the most prevalent, followed by IncFIA (40.0%), IncL (35.4%), IncX3 (32.3%), IncI1 (32.3%), and IncFIIK (29.2%).
Conclusions: We analysed the clonality and resistance determinants of 65 multidrug-resistant (MDR) Enterobacteriaceae recovered in the period from 2016 to 2019 from a large tertiary hospital in Lebanon. NDM variants, OXA-48, and OXA-181 were the most prevalent detected carbapenemases and were mostly linked to the dissemination of IncL, IncX3, and IncF. This study reinforces the need to track the spread and dominance of clinically relevant carbapenemase-encoding plasmids in healthcare settings.
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| http://dx.doi.org/10.1016/j.jgar.2023.07.004 | DOI Listing |
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