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...
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Frontiers Media S.A.
2017-11-01
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| Series: | Frontiers in Microbiology |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fmicb.2017.02135/full |
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| author | Eliana P. Esposito Stefano Gaiarsa Stefano Gaiarsa Mariateresa Del Franco Valeria Crivaro Mariano Bernardo Susanna Cuccurullo Francesca Pennino Maria Triassi Piero Marone Davide Sassera Raffaele Zarrilli Raffaele Zarrilli |
| author_facet | Eliana P. Esposito Stefano Gaiarsa Stefano Gaiarsa Mariateresa Del Franco Valeria Crivaro Mariano Bernardo Susanna Cuccurullo Francesca Pennino Maria Triassi Piero Marone Davide Sassera Raffaele Zarrilli Raffaele Zarrilli |
| author_sort | Eliana P. Esposito |
| collection | DOAJ |
| 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 blaSHV -12 and carbapenem-hydrolyzing metallo-β-lactamase blaV 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 blaV IM-1 into a class I integron, blaSHV -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 blaV IM-1 and blaSHV -12 contributed to the spread of ST104 K. pneumoniae in the NICU of V. Monaldi Hospital in Naples. |
| first_indexed | 2024-12-23T13:33:36Z |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-12-23T13:33:36Z |
| publishDate | 2017-11-01 |
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| spelling | doaj.art-20855db7950248e9ab6e8d21ae57f75f2022-12-21T17:45:05ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2017-11-01810.3389/fmicb.2017.02135297561A 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 NaplesEliana P. Esposito0Stefano Gaiarsa1Stefano Gaiarsa2Mariateresa Del Franco3Valeria Crivaro4Mariano Bernardo5Susanna Cuccurullo6Francesca Pennino7Maria Triassi8Piero Marone9Davide Sassera10Raffaele Zarrilli11Raffaele Zarrilli12Department of Public Health, University of Naples ‘Federico II’, Naples, ItalyDepartment of Bioscience, University of Milan, Milan, ItalyMicrobiology and Virology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, ItalyDepartment of Public Health, University of Naples ‘Federico II’, Naples, ItalyAzienda Ospedaliera di Rilievo Nazionale (AORN) dei Colli, V. Monaldi Hospital, Naples, ItalyAzienda Ospedaliera di Rilievo Nazionale (AORN) dei Colli, V. Monaldi Hospital, Naples, ItalyAzienda Ospedaliera di Rilievo Nazionale (AORN) dei Colli, V. Monaldi Hospital, Naples, ItalyDepartment of Public Health, University of Naples ‘Federico II’, Naples, ItalyDepartment of Public Health, University of Naples ‘Federico II’, Naples, ItalyMicrobiology and Virology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, ItalyDepartment of Biology and Biotechnologies, University of Pavia, Pavia, ItalyDepartment of Public Health, University of Naples ‘Federico II’, Naples, ItalyCentro di Inngegneria Genetica (CEINGE) Biotecnologie Avanzate, Naples, ItalyThe 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 blaSHV -12 and carbapenem-hydrolyzing metallo-β-lactamase blaV 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 blaV IM-1 into a class I integron, blaSHV -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 blaV IM-1 and blaSHV -12 contributed to the spread of ST104 K. pneumoniae in the NICU of V. Monaldi Hospital in Naples.http://journal.frontiersin.org/article/10.3389/fmicb.2017.02135/fullcarbapenemase producing Klebsiella pneumoniaeVIM-1 carbapenemaseIncA/C plasmidhorizontal gene transferneonatal intensive care unit |
| spellingShingle | Eliana P. Esposito Stefano Gaiarsa Stefano Gaiarsa Mariateresa Del Franco Valeria Crivaro Mariano Bernardo Susanna Cuccurullo Francesca Pennino Maria Triassi Piero Marone Davide Sassera Raffaele Zarrilli Raffaele Zarrilli 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 Frontiers in Microbiology carbapenemase producing Klebsiella pneumoniae VIM-1 carbapenemase IncA/C plasmid horizontal gene transfer neonatal intensive care unit |
| 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 | carbapenemase producing Klebsiella pneumoniae VIM-1 carbapenemase IncA/C plasmid horizontal gene transfer neonatal intensive care unit |
| url | http://journal.frontiersin.org/article/10.3389/fmicb.2017.02135/full |
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