Genomic data reveals the emergence of blaKPC-2 and blaCTX-M-15 in E. coli ST648 from rectal swab isolates in the context of hospital surveillance

LEGUINA CAROLINA; GAMBINO ANAHÍ; GARCÍA ALLENDE NATALIA; PRACK MC CORMICK BARBARA; MASSÓ MARIANA; CARRERA PÁEZ LAURA; PIEKAR MARIA; FOX BARBARA; CAMICIA GABRIELA; VARGAS CAROLINA; ALONSO FERNANDO; FERNÁNDEZ-CANIGIA LILIANA; CENTRÓN DANIELA; KNECHT CAMILA; ALVAREZ VERÓNICA ELIZABETH; GONZALEZ MACHUCA ADRIÁN; CAMPOS JOSEFINA; AYALA NÚÑEZ T; DONIS NICOLÁS; QUIROGA, MARÍA PAULA

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Congreso; IUMS Congress, the online edition.; 2022

Theepidemiological success of pandemic KPC carbapenemases was linked to pandemiclineages capable of disseminating plasmids carrying the blaKPC-2 gene on the mobile genetic elementplatform Tn4401. The most frequent plasmids are of the IncF type,followed by IncN, IncX, IncA/C, IncP, IncL/M, IncR, IncH, IncI, IncU and Col,which spread rapidly, especially among the international clones of Escherichia coli and Klebsiella pneumoniae. Our aim was to analyzea carbapenemase producing Escherichia coli strain isolated from hospitalsurveillance. Thestrain HA25pEc was isolated from a rectal swab sample taken on the first day ofhospitalization as part of the hospital epidemiological surveillance protocol.WGS was performed by Illumina MiSeq. Bioinformatic analysis was carried outwith SPAdes 3.9.0, Prodigal, RefSeq, Blast, PlasmidFinder, pubmlst, ResFinderand CARD. Conjugation assays were also performed.HA25pEccorresponds to the first report of E.coli ST648 carrying blaKPC-2and blaCTX-M-15, inLatin America. It possesses 17 antibiotic resistance genes (ARGs) apart from blaKPC-2 and blaCTX-M-15. This strainpossesses the replicons Col(MG828), IncFIA, IncFIB, IncFII and IncR.  blaKPC-2 was identified on the Tn4401(tnpR)-Tn3(tnpA9-IS21(TnpA)-ISKpn7(TnpA)-ISKpn7(TnpA)-blaKPC-2-ISKpn6(TnpA)-ISKpn13(TnpA)-IS5/IS1182(TnpA)genetic platform. Dissemination of the blaKPC-2 gene among E. coli strains belonging to ST648 hasbeen described to be mediated by large plasmids IncN and IncHI2. Since thesereplicons were not found in HA25pEc, it is possible that another plasmid ormechanism is disseminating the blaKPC-2 gene in Argentina.Ourresults reinforce the importance of molecular surveillance to identifyreservoirs and to warn about the spread of new international clones in patientscarrying carbapenemases.