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Genomic dissection of endemic carbapenem resistance reveals metallo-beta-lactamase dissemination through clonal, plasmid and integron transfer

Infections caused by metallo-beta-lactamase-producing organisms (MBLs) are a global health threat. Our understanding of transmission dynamics and how MBLs establish endemicity remains limited. We analysed two decades of bla(IMP-4) evolution in a hospital using sequence data from 270 clinical and env...

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Detalles Bibliográficos
Autores principales: Macesic, Nenad, Hawkey, Jane, Vezina, Ben, Wisniewski, Jessica A., Cottingham, Hugh, Blakeway, Luke V., Harshegyi, Taylor, Pragastis, Katherine, Badoordeen, Gnei Zweena, Dennison, Amanda, Spelman, Denis W., Jenney, Adam W. J., Peleg, Anton Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10409761/
https://www.ncbi.nlm.nih.gov/pubmed/37553339
http://dx.doi.org/10.1038/s41467-023-39915-2
Descripción
Sumario:Infections caused by metallo-beta-lactamase-producing organisms (MBLs) are a global health threat. Our understanding of transmission dynamics and how MBLs establish endemicity remains limited. We analysed two decades of bla(IMP-4) evolution in a hospital using sequence data from 270 clinical and environmental isolates (including 169 completed genomes) and identified the bla(IMP-4) gene across 7 Gram-negative genera, 68 bacterial strains and 7 distinct plasmid types. We showed how an initial multi-species outbreak of conserved IncC plasmids (95 genomes across 37 strains) allowed endemicity to be established through the ability of bla(IMP-4) to disseminate in successful strain-genetic setting pairs we termed propagators, in particular Serratia marcescens and Enterobacter hormaechei. From this reservoir, bla(IMP-4) persisted through diversification of genetic settings that resulted from transfer of bla(IMP-4) plasmids between bacterial hosts and of the integron carrying bla(IMP-4) between plasmids. Our findings provide a framework for understanding endemicity and spread of MBLs and may have broader applicability to other carbapenemase-producing organisms.