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A Novel IncA/C1 Group Conjugative Plasmid, Encoding VIM-1 Metallo-Beta-Lactamase, Mediates the Acquisition of Carbapenem Resistance in ST104 Klebsiella pneumoniae Isolates from Neonates in the Intensive Care Unit of V. Monaldi Hospital in Naples
The emergence of carbapenemase producing Enterobacteriaceae has raised major public health concern. The aim of this study was to investigate the molecular epidemiology and the mechanism of carbapenem resistance acquisition of multidrug-resistant Klebsiella pneumoniae isolates from 20 neonates in the...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2017
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675864/ https://www.ncbi.nlm.nih.gov/pubmed/29163422 http://dx.doi.org/10.3389/fmicb.2017.02135 |
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author | Esposito, Eliana P. Gaiarsa, Stefano Del Franco, Mariateresa Crivaro, Valeria Bernardo, Mariano Cuccurullo, Susanna Pennino, Francesca Triassi, Maria Marone, Piero Sassera, Davide Zarrilli, Raffaele |
author_facet | Esposito, Eliana P. Gaiarsa, Stefano Del Franco, Mariateresa Crivaro, Valeria Bernardo, Mariano Cuccurullo, Susanna Pennino, Francesca Triassi, Maria Marone, Piero Sassera, Davide Zarrilli, Raffaele |
author_sort | Esposito, Eliana P. |
collection | PubMed |
description | The emergence of carbapenemase producing Enterobacteriaceae has raised major public health concern. The aim of this study was to investigate the molecular epidemiology and the mechanism of carbapenem resistance acquisition of multidrug-resistant Klebsiella pneumoniae isolates from 20 neonates in the neonatal intensive care unit (NICU) of the V. Monaldi Hospital in Naples, Italy, from April 2015 to March 2016. Genotype analysis by pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) identified PFGE type A and subtypes A1 and A2 in 17, 2, and 1 isolates, respectively, and assigned all isolates to sequence type (ST) 104. K. pneumoniae isolates were resistant to all classes of β-lactams including carbapenems, fosfomycin, gentamicin, and trimethoprim–sulfamethoxazole, but susceptible to quinolones, amikacin, and colistin. Conjugation experiments demonstrated that resistance to third-generation cephems and imipenem could be transferred along with an IncA/C plasmid containing the extended spectrum β-lactamase bla(SHV -12) and carbapenem-hydrolyzing metallo-β-lactamase bla(V IM-1) genes. The plasmid that we called pIncAC_KP4898 was 156,252 bp in size and included a typical IncA/C backbone, which was assigned to ST12 and core genome (cg) ST12.1 using the IncA/C plasmid MLST (PMLST) scheme. pIncAC_KP4898 showed a mosaic structure with bla(V IM-1) into a class I integron, bla(SHV -12) flanked by IS6 elements, a mercury resistance and a macrolide 2′-phosphotransferase clusters, ant(3″), aph(3″), aacA4, qnrA1, sul1, and dfrA14 conferring resistance to aminoglycosides, quinolones, sulfonamides, and trimethoprim, respectively, several genes predicted to encode transfer functions and proteins involved in DNA transposition. The acquisition of pIncAC_KP4898 carrying bla(V IM-1) and bla(SHV -12) contributed to the spread of ST104 K. pneumoniae in the NICU of V. Monaldi Hospital in Naples. |
format | Online Article Text |
id | pubmed-5675864 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-56758642017-11-21 A Novel IncA/C1 Group Conjugative Plasmid, Encoding VIM-1 Metallo-Beta-Lactamase, Mediates the Acquisition of Carbapenem Resistance in ST104 Klebsiella pneumoniae Isolates from Neonates in the Intensive Care Unit of V. Monaldi Hospital in Naples Esposito, Eliana P. Gaiarsa, Stefano Del Franco, Mariateresa Crivaro, Valeria Bernardo, Mariano Cuccurullo, Susanna Pennino, Francesca Triassi, Maria Marone, Piero Sassera, Davide Zarrilli, Raffaele Front Microbiol Microbiology The emergence of carbapenemase producing Enterobacteriaceae has raised major public health concern. The aim of this study was to investigate the molecular epidemiology and the mechanism of carbapenem resistance acquisition of multidrug-resistant Klebsiella pneumoniae isolates from 20 neonates in the neonatal intensive care unit (NICU) of the V. Monaldi Hospital in Naples, Italy, from April 2015 to March 2016. Genotype analysis by pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) identified PFGE type A and subtypes A1 and A2 in 17, 2, and 1 isolates, respectively, and assigned all isolates to sequence type (ST) 104. K. pneumoniae isolates were resistant to all classes of β-lactams including carbapenems, fosfomycin, gentamicin, and trimethoprim–sulfamethoxazole, but susceptible to quinolones, amikacin, and colistin. Conjugation experiments demonstrated that resistance to third-generation cephems and imipenem could be transferred along with an IncA/C plasmid containing the extended spectrum β-lactamase bla(SHV -12) and carbapenem-hydrolyzing metallo-β-lactamase bla(V IM-1) genes. The plasmid that we called pIncAC_KP4898 was 156,252 bp in size and included a typical IncA/C backbone, which was assigned to ST12 and core genome (cg) ST12.1 using the IncA/C plasmid MLST (PMLST) scheme. pIncAC_KP4898 showed a mosaic structure with bla(V IM-1) into a class I integron, bla(SHV -12) flanked by IS6 elements, a mercury resistance and a macrolide 2′-phosphotransferase clusters, ant(3″), aph(3″), aacA4, qnrA1, sul1, and dfrA14 conferring resistance to aminoglycosides, quinolones, sulfonamides, and trimethoprim, respectively, several genes predicted to encode transfer functions and proteins involved in DNA transposition. The acquisition of pIncAC_KP4898 carrying bla(V IM-1) and bla(SHV -12) contributed to the spread of ST104 K. pneumoniae in the NICU of V. Monaldi Hospital in Naples. Frontiers Media S.A. 2017-11-03 /pmc/articles/PMC5675864/ /pubmed/29163422 http://dx.doi.org/10.3389/fmicb.2017.02135 Text en Copyright © 2017 Esposito, Gaiarsa, Del Franco, Crivaro, Bernardo, Cuccurullo, Pennino, Triassi, Marone, Sassera and Zarrilli. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Microbiology Esposito, Eliana P. Gaiarsa, Stefano Del Franco, Mariateresa Crivaro, Valeria Bernardo, Mariano Cuccurullo, Susanna Pennino, Francesca Triassi, Maria Marone, Piero Sassera, Davide Zarrilli, Raffaele A Novel IncA/C1 Group Conjugative Plasmid, Encoding VIM-1 Metallo-Beta-Lactamase, Mediates the Acquisition of Carbapenem Resistance in ST104 Klebsiella pneumoniae Isolates from Neonates in the Intensive Care Unit of V. Monaldi Hospital in Naples |
title | A Novel IncA/C1 Group Conjugative Plasmid, Encoding VIM-1 Metallo-Beta-Lactamase, Mediates the Acquisition of Carbapenem Resistance in ST104 Klebsiella pneumoniae Isolates from Neonates in the Intensive Care Unit of V. Monaldi Hospital in Naples |
title_full | A Novel IncA/C1 Group Conjugative Plasmid, Encoding VIM-1 Metallo-Beta-Lactamase, Mediates the Acquisition of Carbapenem Resistance in ST104 Klebsiella pneumoniae Isolates from Neonates in the Intensive Care Unit of V. Monaldi Hospital in Naples |
title_fullStr | A Novel IncA/C1 Group Conjugative Plasmid, Encoding VIM-1 Metallo-Beta-Lactamase, Mediates the Acquisition of Carbapenem Resistance in ST104 Klebsiella pneumoniae Isolates from Neonates in the Intensive Care Unit of V. Monaldi Hospital in Naples |
title_full_unstemmed | A Novel IncA/C1 Group Conjugative Plasmid, Encoding VIM-1 Metallo-Beta-Lactamase, Mediates the Acquisition of Carbapenem Resistance in ST104 Klebsiella pneumoniae Isolates from Neonates in the Intensive Care Unit of V. Monaldi Hospital in Naples |
title_short | A Novel IncA/C1 Group Conjugative Plasmid, Encoding VIM-1 Metallo-Beta-Lactamase, Mediates the Acquisition of Carbapenem Resistance in ST104 Klebsiella pneumoniae Isolates from Neonates in the Intensive Care Unit of V. Monaldi Hospital in Naples |
title_sort | novel inca/c1 group conjugative plasmid, encoding vim-1 metallo-beta-lactamase, mediates the acquisition of carbapenem resistance in st104 klebsiella pneumoniae isolates from neonates in the intensive care unit of v. monaldi hospital in naples |
topic | Microbiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675864/ https://www.ncbi.nlm.nih.gov/pubmed/29163422 http://dx.doi.org/10.3389/fmicb.2017.02135 |
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