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Molecular Epidemiology, Antibiotic Resistance, and Virulence Traits of Stenotrophomonas maltophilia Strains Associated With an Outbreak in a Mexican Tertiary Care Hospital

Stenotrophomonas maltophilia, an emerging opportunistic pathogen, is widely distributed in the environment the resistance mechanisms, and virulence factors of this bacterium facilitate its dissemination in hospitals. This study aimed to characterize the molecular epidemiology of S. maltophilia strai...

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Autores principales: Cruz-Córdova, Ariadnna, Mancilla-Rojano, Jetsi, Luna-Pineda, Víctor M., Escalona-Venegas, Gerardo, Cázares-Domínguez, Vicenta, Ormsby, Christopher, Franco-Hernández, Isabel, Zavala-Vega, Sergio, Hernández, Mónica Andrés, Medina-Pelcastre, Marisol, Parra-Ortega, Israel, la Rosa-Zamboni, Daniela De, Ochoa, Sara A., Xicohtencatl-Cortes, Juan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7040173/
https://www.ncbi.nlm.nih.gov/pubmed/32133303
http://dx.doi.org/10.3389/fcimb.2020.00050
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author Cruz-Córdova, Ariadnna
Mancilla-Rojano, Jetsi
Luna-Pineda, Víctor M.
Escalona-Venegas, Gerardo
Cázares-Domínguez, Vicenta
Ormsby, Christopher
Franco-Hernández, Isabel
Zavala-Vega, Sergio
Hernández, Mónica Andrés
Medina-Pelcastre, Marisol
Parra-Ortega, Israel
la Rosa-Zamboni, Daniela De
Ochoa, Sara A.
Xicohtencatl-Cortes, Juan
author_facet Cruz-Córdova, Ariadnna
Mancilla-Rojano, Jetsi
Luna-Pineda, Víctor M.
Escalona-Venegas, Gerardo
Cázares-Domínguez, Vicenta
Ormsby, Christopher
Franco-Hernández, Isabel
Zavala-Vega, Sergio
Hernández, Mónica Andrés
Medina-Pelcastre, Marisol
Parra-Ortega, Israel
la Rosa-Zamboni, Daniela De
Ochoa, Sara A.
Xicohtencatl-Cortes, Juan
author_sort Cruz-Córdova, Ariadnna
collection PubMed
description Stenotrophomonas maltophilia, an emerging opportunistic pathogen, is widely distributed in the environment the resistance mechanisms, and virulence factors of this bacterium facilitate its dissemination in hospitals. This study aimed to characterize the molecular epidemiology of S. maltophilia strains associated with an outbreak in the Children's Hospital of México Federico Gómez (HIMFG). Twenty-one clinical S. maltophilia strains were recovered from cultures of blood and urine samples from 10 pediatric patients at the emergency department, and nine environmental S. maltophilia strains recovered from faucets in the same area were also included. Two of the 10 patients were related with health care-associated infections (HCAIs), and the other eight patients (8/10) were infected with environmental S. maltophilia strains. The outbreak was controlled by monthly disinfection of the faucets in the emergency department. Typing using pulsed-field gel electrophoresis (PFGE) showed a 52% genetic diversity with seven pulsotypes denoted P1–P7 among all S. maltophilia strains. Three pulsotypes (P2, P3, and P7) were identified among both the clinical and environmental S. maltophilia strains and associated with two type sequences (STs), namely, ST304 and ST24. Moreover, 80% (24/30) of the strains exhibited resistance mainly to tetracycline, 76.66% (23/30) to trimethoprim-sulfamethoxazole, and 23.33% (7/30) to the extended-spectrum β-lactamase (ESBL) phenotype. The main resistance genes identified by multiplex PCR were sul1 in 100% (30/30), qnr in 86.66% (26/30), and intl1 in 80% (24/30) of the samples, respectively. Furthermore, the pilU, hlylII, and rmlA genes were identified in 96.6% (29/30), 90% (27/30), and 83.33% (25/30) of the samples, respectively. Additionally, 76.66% (23/30) of the S. maltophilia strains exhibited high swimming motility, 46.66% (14/30) showed moderate biofilm formation capacity, 43.33% (13/30) displayed moderate twitching motility, and 20% (6/30) exhibited high adherence. The clinical S. maltophilia strains isolated from blood most strongly adhered to HTB-9 cells. In conclusion, the molecular epidemiology and some of the features such as resistance, and virulence genes associated with colonization patterns are pathogenic attributes that can promote S. maltophilia dissemination, persistence, and facilitate the outbreak that occurred in the HIMFG. This study supports the need for faucet disinfection as a control strategy for clinical outbreaks.
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spelling pubmed-70401732020-03-04 Molecular Epidemiology, Antibiotic Resistance, and Virulence Traits of Stenotrophomonas maltophilia Strains Associated With an Outbreak in a Mexican Tertiary Care Hospital Cruz-Córdova, Ariadnna Mancilla-Rojano, Jetsi Luna-Pineda, Víctor M. Escalona-Venegas, Gerardo Cázares-Domínguez, Vicenta Ormsby, Christopher Franco-Hernández, Isabel Zavala-Vega, Sergio Hernández, Mónica Andrés Medina-Pelcastre, Marisol Parra-Ortega, Israel la Rosa-Zamboni, Daniela De Ochoa, Sara A. Xicohtencatl-Cortes, Juan Front Cell Infect Microbiol Cellular and Infection Microbiology Stenotrophomonas maltophilia, an emerging opportunistic pathogen, is widely distributed in the environment the resistance mechanisms, and virulence factors of this bacterium facilitate its dissemination in hospitals. This study aimed to characterize the molecular epidemiology of S. maltophilia strains associated with an outbreak in the Children's Hospital of México Federico Gómez (HIMFG). Twenty-one clinical S. maltophilia strains were recovered from cultures of blood and urine samples from 10 pediatric patients at the emergency department, and nine environmental S. maltophilia strains recovered from faucets in the same area were also included. Two of the 10 patients were related with health care-associated infections (HCAIs), and the other eight patients (8/10) were infected with environmental S. maltophilia strains. The outbreak was controlled by monthly disinfection of the faucets in the emergency department. Typing using pulsed-field gel electrophoresis (PFGE) showed a 52% genetic diversity with seven pulsotypes denoted P1–P7 among all S. maltophilia strains. Three pulsotypes (P2, P3, and P7) were identified among both the clinical and environmental S. maltophilia strains and associated with two type sequences (STs), namely, ST304 and ST24. Moreover, 80% (24/30) of the strains exhibited resistance mainly to tetracycline, 76.66% (23/30) to trimethoprim-sulfamethoxazole, and 23.33% (7/30) to the extended-spectrum β-lactamase (ESBL) phenotype. The main resistance genes identified by multiplex PCR were sul1 in 100% (30/30), qnr in 86.66% (26/30), and intl1 in 80% (24/30) of the samples, respectively. Furthermore, the pilU, hlylII, and rmlA genes were identified in 96.6% (29/30), 90% (27/30), and 83.33% (25/30) of the samples, respectively. Additionally, 76.66% (23/30) of the S. maltophilia strains exhibited high swimming motility, 46.66% (14/30) showed moderate biofilm formation capacity, 43.33% (13/30) displayed moderate twitching motility, and 20% (6/30) exhibited high adherence. The clinical S. maltophilia strains isolated from blood most strongly adhered to HTB-9 cells. In conclusion, the molecular epidemiology and some of the features such as resistance, and virulence genes associated with colonization patterns are pathogenic attributes that can promote S. maltophilia dissemination, persistence, and facilitate the outbreak that occurred in the HIMFG. This study supports the need for faucet disinfection as a control strategy for clinical outbreaks. Frontiers Media S.A. 2020-02-18 /pmc/articles/PMC7040173/ /pubmed/32133303 http://dx.doi.org/10.3389/fcimb.2020.00050 Text en Copyright © 2020 Cruz-Córdova, Mancilla-Rojano, Luna-Pineda, Escalona-Venegas, Cázares-Domínguez, Ormsby, Franco-Hernández, Zavala-Vega, Hernández, Medina-Pelcastre, Parra-Ortega, Rosa-Zamboni, Ochoa and Xicohtencatl-Cortes. 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) and the copyright owner(s) 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 Cellular and Infection Microbiology
Cruz-Córdova, Ariadnna
Mancilla-Rojano, Jetsi
Luna-Pineda, Víctor M.
Escalona-Venegas, Gerardo
Cázares-Domínguez, Vicenta
Ormsby, Christopher
Franco-Hernández, Isabel
Zavala-Vega, Sergio
Hernández, Mónica Andrés
Medina-Pelcastre, Marisol
Parra-Ortega, Israel
la Rosa-Zamboni, Daniela De
Ochoa, Sara A.
Xicohtencatl-Cortes, Juan
Molecular Epidemiology, Antibiotic Resistance, and Virulence Traits of Stenotrophomonas maltophilia Strains Associated With an Outbreak in a Mexican Tertiary Care Hospital
title Molecular Epidemiology, Antibiotic Resistance, and Virulence Traits of Stenotrophomonas maltophilia Strains Associated With an Outbreak in a Mexican Tertiary Care Hospital
title_full Molecular Epidemiology, Antibiotic Resistance, and Virulence Traits of Stenotrophomonas maltophilia Strains Associated With an Outbreak in a Mexican Tertiary Care Hospital
title_fullStr Molecular Epidemiology, Antibiotic Resistance, and Virulence Traits of Stenotrophomonas maltophilia Strains Associated With an Outbreak in a Mexican Tertiary Care Hospital
title_full_unstemmed Molecular Epidemiology, Antibiotic Resistance, and Virulence Traits of Stenotrophomonas maltophilia Strains Associated With an Outbreak in a Mexican Tertiary Care Hospital
title_short Molecular Epidemiology, Antibiotic Resistance, and Virulence Traits of Stenotrophomonas maltophilia Strains Associated With an Outbreak in a Mexican Tertiary Care Hospital
title_sort molecular epidemiology, antibiotic resistance, and virulence traits of stenotrophomonas maltophilia strains associated with an outbreak in a mexican tertiary care hospital
topic Cellular and Infection Microbiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7040173/
https://www.ncbi.nlm.nih.gov/pubmed/32133303
http://dx.doi.org/10.3389/fcimb.2020.00050
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