First detection in Spain of NDM-1-producing Pseudomonas aeruginosa in two patients transferred from Ukraine to a university hospital
Objectives: Carbapenemase-mediated carbapenem resistance in Pseudomonas aeruginosa is a relevant health problem. We detected for the first time in Spain two clinical NDM-producing P. aeruginosa (NDM-Pa) isolates in two Ukrainian patients admitted to our hospital between April and August 2022. Method...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-03-01
|
| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716523002345 |
| _version_ | 1797249155165323264 |
|---|---|
| author | Marta Hernández-García Margarita Cabello Manuel Ponce-Alonso Pedro M. Herrador-Gómez Francesca Gioia Javier Cobo Rafael Cantón Patricia Ruiz-Garbajosa |
| author_facet | Marta Hernández-García Margarita Cabello Manuel Ponce-Alonso Pedro M. Herrador-Gómez Francesca Gioia Javier Cobo Rafael Cantón Patricia Ruiz-Garbajosa |
| author_sort | Marta Hernández-García |
| collection | DOAJ |
| description | Objectives: Carbapenemase-mediated carbapenem resistance in Pseudomonas aeruginosa is a relevant health problem. We detected for the first time in Spain two clinical NDM-producing P. aeruginosa (NDM-Pa) isolates in two Ukrainian patients admitted to our hospital between April and August 2022. Methods: Antimicrobial susceptibility was studied by microdilution and MIC gradient strips (EUCAST-2022 criteria). Carbapenemase genes were detected by the Xpert Carba-R and immunochromatography assays. WGS (Illumina and Oxford-Nanopore) was also performed. Results: In May 2022, we detected an NDM-Pa in a sternotomy wound in a patient. In June-2022, a second NDM-Pa along with an OXA-48-Klebsiella pneumoniae (OXA-48-Kp) isolate was detected in a mandibular abscess from an unrelated patient. Moreover, an NDM+OXA-48-K. pneumoniae (NDM+OXA-48-Kp) was also found in a rectal sample of this patient. Both patients had undergone surgery in Ukraine before their transfer to our hospital. NDM-Pa isolates were resistant to all tested antimicrobials with the exception of aztreonam (MIC = 8 mg/L), colistin (MIC =2 mg/L) and cefiderocol (MIC range = 0.75–2 mg/L). WGS confirmed that both P. aeruginosa isolates were NDM-1 producers, belonged to ST773 and shared an identical resistome. blaNDM-1 was located on a ∼117-Kb chromosomally integrated integrative conjugative element (ICE). OXA-48-Kp and NDM+OXA-48-Kp belonged to ST147 and contained blaOXA-48 on an identical ∼300-Kb IncHIB-plasmid. blaNDM-1 was located on a 51-Kb IncFIB-plasmid only found in NDM+OXA-48-Kp. Conclusions: This is the first description of NDM-Pa in Spain. We highlight the threat of further cross-border dissemination of NDM-1 through P. aeruginosa along with K. pneumoniae high-risk clones also carrying OXA-48, which draws a complex epidemiological scenario. |
| first_indexed | 2024-04-24T20:25:59Z |
| format | Article |
| id | doaj.art-86b33834a81f41099eb320c67376f8cb |
| institution | Directory Open Access Journal |
| issn | 2213-7165 |
| language | English |
| last_indexed | 2024-04-24T20:25:59Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj.art-86b33834a81f41099eb320c67376f8cb2024-03-22T05:39:27ZengElsevierJournal of Global Antimicrobial Resistance2213-71652024-03-0136105111First detection in Spain of NDM-1-producing Pseudomonas aeruginosa in two patients transferred from Ukraine to a university hospitalMarta Hernández-García0Margarita Cabello1Manuel Ponce-Alonso2Pedro M. Herrador-Gómez3Francesca Gioia4Javier Cobo5Rafael Cantón6Patricia Ruiz-Garbajosa7Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 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, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, SpainServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, SpainServicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, SpainCIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, SpainServicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Corresponding author. Mailing address: Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Carretera de Colmenar Km 9,1. 28034, Madrid. Spain.Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, SpainObjectives: Carbapenemase-mediated carbapenem resistance in Pseudomonas aeruginosa is a relevant health problem. We detected for the first time in Spain two clinical NDM-producing P. aeruginosa (NDM-Pa) isolates in two Ukrainian patients admitted to our hospital between April and August 2022. Methods: Antimicrobial susceptibility was studied by microdilution and MIC gradient strips (EUCAST-2022 criteria). Carbapenemase genes were detected by the Xpert Carba-R and immunochromatography assays. WGS (Illumina and Oxford-Nanopore) was also performed. Results: In May 2022, we detected an NDM-Pa in a sternotomy wound in a patient. In June-2022, a second NDM-Pa along with an OXA-48-Klebsiella pneumoniae (OXA-48-Kp) isolate was detected in a mandibular abscess from an unrelated patient. Moreover, an NDM+OXA-48-K. pneumoniae (NDM+OXA-48-Kp) was also found in a rectal sample of this patient. Both patients had undergone surgery in Ukraine before their transfer to our hospital. NDM-Pa isolates were resistant to all tested antimicrobials with the exception of aztreonam (MIC = 8 mg/L), colistin (MIC =2 mg/L) and cefiderocol (MIC range = 0.75–2 mg/L). WGS confirmed that both P. aeruginosa isolates were NDM-1 producers, belonged to ST773 and shared an identical resistome. blaNDM-1 was located on a ∼117-Kb chromosomally integrated integrative conjugative element (ICE). OXA-48-Kp and NDM+OXA-48-Kp belonged to ST147 and contained blaOXA-48 on an identical ∼300-Kb IncHIB-plasmid. blaNDM-1 was located on a 51-Kb IncFIB-plasmid only found in NDM+OXA-48-Kp. Conclusions: This is the first description of NDM-Pa in Spain. We highlight the threat of further cross-border dissemination of NDM-1 through P. aeruginosa along with K. pneumoniae high-risk clones also carrying OXA-48, which draws a complex epidemiological scenario.http://www.sciencedirect.com/science/article/pii/S2213716523002345Pseudomonas aeruginosaNDM carbapenemaseNDM-1+OXA-48-Klebsiella pneumoniaeUkraineWhole genome sequencing |
| spellingShingle | Marta Hernández-García Margarita Cabello Manuel Ponce-Alonso Pedro M. Herrador-Gómez Francesca Gioia Javier Cobo Rafael Cantón Patricia Ruiz-Garbajosa First detection in Spain of NDM-1-producing Pseudomonas aeruginosa in two patients transferred from Ukraine to a university hospital Journal of Global Antimicrobial Resistance Pseudomonas aeruginosa NDM carbapenemase NDM-1+OXA-48-Klebsiella pneumoniae Ukraine Whole genome sequencing |
| title | First detection in Spain of NDM-1-producing Pseudomonas aeruginosa in two patients transferred from Ukraine to a university hospital |
| title_full | First detection in Spain of NDM-1-producing Pseudomonas aeruginosa in two patients transferred from Ukraine to a university hospital |
| title_fullStr | First detection in Spain of NDM-1-producing Pseudomonas aeruginosa in two patients transferred from Ukraine to a university hospital |
| title_full_unstemmed | First detection in Spain of NDM-1-producing Pseudomonas aeruginosa in two patients transferred from Ukraine to a university hospital |
| title_short | First detection in Spain of NDM-1-producing Pseudomonas aeruginosa in two patients transferred from Ukraine to a university hospital |
| title_sort | first detection in spain of ndm 1 producing pseudomonas aeruginosa in two patients transferred from ukraine to a university hospital |
| topic | Pseudomonas aeruginosa NDM carbapenemase NDM-1+OXA-48-Klebsiella pneumoniae Ukraine Whole genome sequencing |
| url | http://www.sciencedirect.com/science/article/pii/S2213716523002345 |
| work_keys_str_mv | AT martahernandezgarcia firstdetectioninspainofndm1producingpseudomonasaeruginosaintwopatientstransferredfromukrainetoauniversityhospital AT margaritacabello firstdetectioninspainofndm1producingpseudomonasaeruginosaintwopatientstransferredfromukrainetoauniversityhospital AT manuelponcealonso firstdetectioninspainofndm1producingpseudomonasaeruginosaintwopatientstransferredfromukrainetoauniversityhospital AT pedromherradorgomez firstdetectioninspainofndm1producingpseudomonasaeruginosaintwopatientstransferredfromukrainetoauniversityhospital AT francescagioia firstdetectioninspainofndm1producingpseudomonasaeruginosaintwopatientstransferredfromukrainetoauniversityhospital AT javiercobo firstdetectioninspainofndm1producingpseudomonasaeruginosaintwopatientstransferredfromukrainetoauniversityhospital AT rafaelcanton firstdetectioninspainofndm1producingpseudomonasaeruginosaintwopatientstransferredfromukrainetoauniversityhospital AT patriciaruizgarbajosa firstdetectioninspainofndm1producingpseudomonasaeruginosaintwopatientstransferredfromukrainetoauniversityhospital |