Objective: We aimed to describe a colistin (COL)-resistant (R) (Cvi) isolate from a septic patient in Argentina expressing a previously unknown gene, .
Methods: In 2019, a 12 year old child was injured with a thorn in a lagoon. The child was hospitalized due to sepsis and multiple abscesses. Cvi was isolated from skin and soft tissue and tracheal aspirate. The patient was successfully treated with imipenem (IMI) plus amikacin. Antimicrobial susceptibility was assessed by disk diffusion, broth microdilution, and the E-test. Carbapenemase activity was assayed by double-disk synergy and microbiological tests. Resistance, virulence, and additional gene searches were performed by in silico analysis of sequences obtained by whole-genome sequencing (WGS). A maximum likelihood phylogenetic tree was built with public Cvi genomes.
Results: R was seen for IMI and COL. Expression of a metallo-β-lactamase was confirmed. Genome analysis revealed , a subclass B2 metallo-β-lactamase with 62.66% ID with CphA from (WP081086394). R to COL could be attributed to the and genes. Virulence factors required for invasion and toxicity were also found. No plasmids were detected. The phylogeny tree showed two main clades with geographical distinction, and the isolate studied here stands alone in a branch closely related to two clinical isolates from the USA.
Conclusions: This is the second report of infection by Cvi in Argentina. This pathogen carried a new gene, , a metallo-β-lactamase that can be detected by routine methods. Prompt suspicion of infection is crucial to treating this rare pathogen rapidly and properly.
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