A long-term survey of Serratia spp. bloodstream infections revealed an increase of antimicrobial resistance involving adult population
ABSTRACTSerratia spp. is a well-recognized pathogen in neonates; however, limited data are available in adults. We studied microbiological and clinical characteristics of Serratia spp. causing bloodstream infections (BSI) in our institution (January 2005–July 2020). Overall, 141 BSI episodes affecti...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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American Society for Microbiology
2024-02-01
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| Series: | Microbiology Spectrum |
| Subjects: | |
| Online Access: | https://journals.asm.org/doi/10.1128/spectrum.02762-23 |
| _version_ | 1827357036357091328 |
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| author | Blanca Pérez-Viso Marta Hernández-García Concepción M. Rodríguez Miguel D. Fernández-de-Bobadilla María Isabel Serrano-Tomás Ana María Sánchez-Díaz José Avendaño-Ortiz Teresa M. Coque Patricia Ruiz-Garbajosa Rosa del Campo Rafael Cantón |
| author_facet | Blanca Pérez-Viso Marta Hernández-García Concepción M. Rodríguez Miguel D. Fernández-de-Bobadilla María Isabel Serrano-Tomás Ana María Sánchez-Díaz José Avendaño-Ortiz Teresa M. Coque Patricia Ruiz-Garbajosa Rosa del Campo Rafael Cantón |
| author_sort | Blanca Pérez-Viso |
| collection | DOAJ |
| description | ABSTRACTSerratia spp. is a well-recognized pathogen in neonates; however, limited data are available in adults. We studied microbiological and clinical characteristics of Serratia spp. causing bloodstream infections (BSI) in our institution (January 2005–July 2020). Overall, 141 BSI episodes affecting 139 patients were identified and medical records reviewed. Antimicrobial susceptibility was recovered from our informatics system and 118 isolates from 116 patients were available for further microbiological studies. Whole genome sequencing (WGS) was completed in 107 isolates. Incidence of Serratia BSI was 0.3/1000 overall admissions (range 0.12–0.60), with maximum prevalence (27 episodes, 19.1%) during 2017–2018. Relevant patients’ clinical characteristics were 71.9% ≥60 years (n = 100), with high comorbidity rates (49%, ≥2), 23 (74.2%) of them died within 1 month of the BSI episode. WGS identified all isolates as Serratia marcescens when Kraken bioinformatics taxonomic tool was used despite some which were identified as Serratia nematodiphila (32/118) or Serratia ureilytica (5/118) by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Nevertheless, when using MASH distance, Serratia nevei (63/107), S. ureilytica (38/107), and S. marcescens (6/107) were assigned. Carbapenemase (blaVIM-1) and extended-spectrum β-lactases (ESBL) (blaSHV-12) genes were found in seven and three isolates, respectively, one of them expressing both genes. The worldwide-disseminated IncL/M scaffold plasmid was identified in six VIM producers. Four genotypes were established based on their virulence factors and resistome. Serratia spp. emerged as a relevant nosocomial pathogen causing BSI in elderly patients in our hospital, particularly in recent years with a remarkable increase in antibiotic resistance. ESBL and carbapenemases production related to plasmid dissemination are particularly noteworthy.IMPORTANCESerratia spp. is the third most frequent pathogen involved in outbreaks at neonatal facilities and is primarily associated with bacteremia episodes. In this study, we characterized all causing bloodstream infection (BSI) in patients admitted to our hospital during a 16-year period (2005–2020). Despite having no neonatal intensive care unit in our hospital, this study revealed that Serratia spp. is a relevant pathogen causing BSI in elderly patients with high comorbidity rates. A significant increase of antimicrobial resistance was detected over time, particularly in 2020 and coinciding with the coronavirus disease (COVID-19) pandemic and nosocomial spread of multidrug-resistant Serratia spp. isolates. extended-spectrum β-lactases and carbapenemases genes associated with plasmid dissemination, typically detected in other Enterobacterales species, were also identified, reinforcing the role of Serratia spp. in the antimicrobial resistance landscape. Additionally, this work highlights the need to reclassify the species of Serratia, since discrepancies were observed in the identification when using different tools. |
| first_indexed | 2024-03-08T05:18:37Z |
| format | Article |
| id | doaj.art-04fd2ffe080e499d9e2b8d0f768803fa |
| institution | Directory Open Access Journal |
| issn | 2165-0497 |
| language | English |
| last_indexed | 2024-03-08T05:18:37Z |
| publishDate | 2024-02-01 |
| publisher | American Society for Microbiology |
| record_format | Article |
| series | Microbiology Spectrum |
| spelling | doaj.art-04fd2ffe080e499d9e2b8d0f768803fa2024-02-06T14:04:55ZengAmerican Society for MicrobiologyMicrobiology Spectrum2165-04972024-02-0112210.1128/spectrum.02762-23A long-term survey of Serratia spp. bloodstream infections revealed an increase of antimicrobial resistance involving adult populationBlanca Pérez-Viso0Marta Hernández-García1Concepción M. Rodríguez2Miguel D. Fernández-de-Bobadilla3María Isabel Serrano-Tomás4Ana María Sánchez-Díaz5José Avendaño-Ortiz6Teresa M. Coque7Patricia Ruiz-Garbajosa8Rosa del Campo9Rafael Cantón10Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, SpainServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, SpainServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, SpainServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, SpainServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, SpainServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, SpainServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, SpainServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, SpainServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, SpainServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, SpainServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, SpainABSTRACTSerratia spp. is a well-recognized pathogen in neonates; however, limited data are available in adults. We studied microbiological and clinical characteristics of Serratia spp. causing bloodstream infections (BSI) in our institution (January 2005–July 2020). Overall, 141 BSI episodes affecting 139 patients were identified and medical records reviewed. Antimicrobial susceptibility was recovered from our informatics system and 118 isolates from 116 patients were available for further microbiological studies. Whole genome sequencing (WGS) was completed in 107 isolates. Incidence of Serratia BSI was 0.3/1000 overall admissions (range 0.12–0.60), with maximum prevalence (27 episodes, 19.1%) during 2017–2018. Relevant patients’ clinical characteristics were 71.9% ≥60 years (n = 100), with high comorbidity rates (49%, ≥2), 23 (74.2%) of them died within 1 month of the BSI episode. WGS identified all isolates as Serratia marcescens when Kraken bioinformatics taxonomic tool was used despite some which were identified as Serratia nematodiphila (32/118) or Serratia ureilytica (5/118) by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Nevertheless, when using MASH distance, Serratia nevei (63/107), S. ureilytica (38/107), and S. marcescens (6/107) were assigned. Carbapenemase (blaVIM-1) and extended-spectrum β-lactases (ESBL) (blaSHV-12) genes were found in seven and three isolates, respectively, one of them expressing both genes. The worldwide-disseminated IncL/M scaffold plasmid was identified in six VIM producers. Four genotypes were established based on their virulence factors and resistome. Serratia spp. emerged as a relevant nosocomial pathogen causing BSI in elderly patients in our hospital, particularly in recent years with a remarkable increase in antibiotic resistance. ESBL and carbapenemases production related to plasmid dissemination are particularly noteworthy.IMPORTANCESerratia spp. is the third most frequent pathogen involved in outbreaks at neonatal facilities and is primarily associated with bacteremia episodes. In this study, we characterized all causing bloodstream infection (BSI) in patients admitted to our hospital during a 16-year period (2005–2020). Despite having no neonatal intensive care unit in our hospital, this study revealed that Serratia spp. is a relevant pathogen causing BSI in elderly patients with high comorbidity rates. A significant increase of antimicrobial resistance was detected over time, particularly in 2020 and coinciding with the coronavirus disease (COVID-19) pandemic and nosocomial spread of multidrug-resistant Serratia spp. isolates. extended-spectrum β-lactases and carbapenemases genes associated with plasmid dissemination, typically detected in other Enterobacterales species, were also identified, reinforcing the role of Serratia spp. in the antimicrobial resistance landscape. Additionally, this work highlights the need to reclassify the species of Serratia, since discrepancies were observed in the identification when using different tools.https://journals.asm.org/doi/10.1128/spectrum.02762-23bacteremiabloodstream infectionsSerratia spp.retrospective studywhole genome sequencing |
| spellingShingle | Blanca Pérez-Viso Marta Hernández-García Concepción M. Rodríguez Miguel D. Fernández-de-Bobadilla María Isabel Serrano-Tomás Ana María Sánchez-Díaz José Avendaño-Ortiz Teresa M. Coque Patricia Ruiz-Garbajosa Rosa del Campo Rafael Cantón A long-term survey of Serratia spp. bloodstream infections revealed an increase of antimicrobial resistance involving adult population Microbiology Spectrum bacteremia bloodstream infections Serratia spp. retrospective study whole genome sequencing |
| title | A long-term survey of Serratia spp. bloodstream infections revealed an increase of antimicrobial resistance involving adult population |
| title_full | A long-term survey of Serratia spp. bloodstream infections revealed an increase of antimicrobial resistance involving adult population |
| title_fullStr | A long-term survey of Serratia spp. bloodstream infections revealed an increase of antimicrobial resistance involving adult population |
| title_full_unstemmed | A long-term survey of Serratia spp. bloodstream infections revealed an increase of antimicrobial resistance involving adult population |
| title_short | A long-term survey of Serratia spp. bloodstream infections revealed an increase of antimicrobial resistance involving adult population |
| title_sort | long term survey of serratia spp bloodstream infections revealed an increase of antimicrobial resistance involving adult population |
| topic | bacteremia bloodstream infections Serratia spp. retrospective study whole genome sequencing |
| url | https://journals.asm.org/doi/10.1128/spectrum.02762-23 |
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