Carbapenem-Resistant and ESBL-Producing Enterobacterales Emerging in Central Texas
Jennifer K Parker,1 Richard Gu,1 Gregory A Estrera,1 Betsy Kirkpatrick,2 Dusten T Rose,3 Despoina AI Mavridou,1,4 Kristin E Mondy,5 Bryan W Davies1,4 1Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, USA; 2Austin Public Health, City of Austin, Austin, TX, USA; 3Dep...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-03-01
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| Series: | Infection and Drug Resistance |
| Subjects: | |
| Online Access: | https://www.dovepress.com/carbapenem-resistant-and-esbl-producing-enterobacterales-emerging-in-c-peer-reviewed-fulltext-article-IDR |
| _version_ | 1828000144149184512 |
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| author | Parker JK Gu R Estrera GA Kirkpatrick B Rose DT Mavridou DAI Mondy KE Davies BW |
| author_facet | Parker JK Gu R Estrera GA Kirkpatrick B Rose DT Mavridou DAI Mondy KE Davies BW |
| author_sort | Parker JK |
| collection | DOAJ |
| description | Jennifer K Parker,1 Richard Gu,1 Gregory A Estrera,1 Betsy Kirkpatrick,2 Dusten T Rose,3 Despoina AI Mavridou,1,4 Kristin E Mondy,5 Bryan W Davies1,4 1Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, USA; 2Austin Public Health, City of Austin, Austin, TX, USA; 3Department of Pharmacy, Ascension Seton, Dell Seton Medical Center at The University of Texas, Austin, TX, USA; 4John Ring LaMontagne Center for Infectious Diseases, The University of Texas at Austin, Austin, TX, USA; 5Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, TX, USACorrespondence: Bryan W Davies, Email bwdavies@utexas.eduPurpose: Carbapenem-resistant Enterobacterales (CRE) are subject to intense global monitoring in an attempt to maintain awareness of prevalent and emerging resistance mechanisms and to inform treatment and infection prevention strategies. CRE and extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales are not usually examined collectively in regards to their shared pool of resistance determinants. Here, we genetically and phenotypically assess clinical isolates of CRE and extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales in the growing region of Central Texas, where CRE are emergent and occurrence of non-carbapenemase-producing-CRE (non-CP-CRE) infections is increasing.Methods: CRE (n=16) and ESBL-producing Enterobacterales (n=116) isolates were acquired from a regional hospital in Central Texas between December 2018 and January 2020. Isolates were assessed genetically and phenotypically using antibiotic susceptibility testing, targeted PCR, and whole genome sequencing.Results: CRE infections are increasing in incidence in Central Texas, and Klebsiella pneumoniae is causing the majority of these infections. Moreover, K. pneumoniae sequence type (ST) 307 is commonly found among both non-CP-CRE and EBSL-producing strains. Isolates carry similar plasmids harboring the gene for the ESBL CTX-M-15 and belong to the global lineage, rather than the Texas lineage, of ST307. Antibiotic resistance profiles, sequence data, and clinical records suggest that porin mutations may promote the transition of ST307 isolates from ESBL-producing to non-CP-CRE. In addition to antibiotic resistance mechanisms, several CRE isolates harbor active colicinogenic plasmids, which might influence the competitiveness of these bacteria during patient colonization.Conclusion: K. pneumoniae of the global ST307 lineage is circulating in Central Texas and is responsible for both non-CP CRE and ESBL-producing Enterobacterales infections. Enhanced surveillance is needed to understand the possible routes for the emergence of non-CP-CRE from EBSL-producing strains.Keywords: beta-lactam, Klebsiella, colicin, genetics, carbapenemase |
| first_indexed | 2024-04-10T06:10:28Z |
| format | Article |
| id | doaj.art-3e42254d38a34336be789266f8ba87af |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-04-10T06:10:28Z |
| publishDate | 2023-03-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-3e42254d38a34336be789266f8ba87af2023-03-02T18:11:56ZengDove Medical PressInfection and Drug Resistance1178-69732023-03-01Volume 161249126181997Carbapenem-Resistant and ESBL-Producing Enterobacterales Emerging in Central TexasParker JKGu REstrera GAKirkpatrick BRose DTMavridou DAIMondy KEDavies BWJennifer K Parker,1 Richard Gu,1 Gregory A Estrera,1 Betsy Kirkpatrick,2 Dusten T Rose,3 Despoina AI Mavridou,1,4 Kristin E Mondy,5 Bryan W Davies1,4 1Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, USA; 2Austin Public Health, City of Austin, Austin, TX, USA; 3Department of Pharmacy, Ascension Seton, Dell Seton Medical Center at The University of Texas, Austin, TX, USA; 4John Ring LaMontagne Center for Infectious Diseases, The University of Texas at Austin, Austin, TX, USA; 5Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, TX, USACorrespondence: Bryan W Davies, Email bwdavies@utexas.eduPurpose: Carbapenem-resistant Enterobacterales (CRE) are subject to intense global monitoring in an attempt to maintain awareness of prevalent and emerging resistance mechanisms and to inform treatment and infection prevention strategies. CRE and extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales are not usually examined collectively in regards to their shared pool of resistance determinants. Here, we genetically and phenotypically assess clinical isolates of CRE and extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales in the growing region of Central Texas, where CRE are emergent and occurrence of non-carbapenemase-producing-CRE (non-CP-CRE) infections is increasing.Methods: CRE (n=16) and ESBL-producing Enterobacterales (n=116) isolates were acquired from a regional hospital in Central Texas between December 2018 and January 2020. Isolates were assessed genetically and phenotypically using antibiotic susceptibility testing, targeted PCR, and whole genome sequencing.Results: CRE infections are increasing in incidence in Central Texas, and Klebsiella pneumoniae is causing the majority of these infections. Moreover, K. pneumoniae sequence type (ST) 307 is commonly found among both non-CP-CRE and EBSL-producing strains. Isolates carry similar plasmids harboring the gene for the ESBL CTX-M-15 and belong to the global lineage, rather than the Texas lineage, of ST307. Antibiotic resistance profiles, sequence data, and clinical records suggest that porin mutations may promote the transition of ST307 isolates from ESBL-producing to non-CP-CRE. In addition to antibiotic resistance mechanisms, several CRE isolates harbor active colicinogenic plasmids, which might influence the competitiveness of these bacteria during patient colonization.Conclusion: K. pneumoniae of the global ST307 lineage is circulating in Central Texas and is responsible for both non-CP CRE and ESBL-producing Enterobacterales infections. Enhanced surveillance is needed to understand the possible routes for the emergence of non-CP-CRE from EBSL-producing strains.Keywords: beta-lactam, Klebsiella, colicin, genetics, carbapenemasehttps://www.dovepress.com/carbapenem-resistant-and-esbl-producing-enterobacterales-emerging-in-c-peer-reviewed-fulltext-article-IDRbeta-lactamklebsiellacolicingeneticscarbapenemase |
| spellingShingle | Parker JK Gu R Estrera GA Kirkpatrick B Rose DT Mavridou DAI Mondy KE Davies BW Carbapenem-Resistant and ESBL-Producing Enterobacterales Emerging in Central Texas Infection and Drug Resistance beta-lactam klebsiella colicin genetics carbapenemase |
| title | Carbapenem-Resistant and ESBL-Producing Enterobacterales Emerging in Central Texas |
| title_full | Carbapenem-Resistant and ESBL-Producing Enterobacterales Emerging in Central Texas |
| title_fullStr | Carbapenem-Resistant and ESBL-Producing Enterobacterales Emerging in Central Texas |
| title_full_unstemmed | Carbapenem-Resistant and ESBL-Producing Enterobacterales Emerging in Central Texas |
| title_short | Carbapenem-Resistant and ESBL-Producing Enterobacterales Emerging in Central Texas |
| title_sort | carbapenem resistant and esbl producing enterobacterales emerging in central texas |
| topic | beta-lactam klebsiella colicin genetics carbapenemase |
| url | https://www.dovepress.com/carbapenem-resistant-and-esbl-producing-enterobacterales-emerging-in-c-peer-reviewed-fulltext-article-IDR |
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