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; KNECHT CAMILA; GAMBINO ANAHI SAMANTA; ALLENDE, NATALIA GARCÍA; ALVAREZ, VERONICA ELIZABETH; BARBARA PRACK MC CORMICK; MASSO, MARIANA; GONZALEZ MACHUCA ADRIAN; CARRERA PAEZ LAURA; PIEKAR MARIA; CAMPOS JOSEFINA; FOX, BARBARA; CAMICIA GABRIELA; AYALA OLINCA; ALONSO FERNANDO; DONIS NICOLAS; CENTRON DANIELA; QUIROGA MARIA PAULA

Congreso; IUMS Congress, the online edition. 2022; 2022

The epidemiological success of pandemic KPC carbapenemases was linked to pandemic lineages capable of disseminating plasmids carrying the blaKPC-2 gene on the mobile genetic element platform 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 analyze a carbapenemase producing Escherichia coli strain isolated from hospital surveillance.The strain HA25pEc was isolated from a rectal swab sample taken on the first day of hospitalization as part of the hospital epidemiological surveillance protocol. WGS was performed by Illumina MiSeq. Bioinformatic analysis was carried out with ResFinder and CARD. Conjugation assays were also performed.HA25pEc corresponds to the first report of E. coli ST648 carrying blaKPC-2 and blaCTX-M-15, in Latin America. It possesses 17 antibiotic resistance genes (ARGs) apart from blaKPC-2 and blaCTX-M-15. This strain possesses 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 has been described to be mediated by large plasmids IncN and IncHI2. Since these replicons were not found in HA25pEc, it is possible that another plasmid or mechanism is disseminating the blaKPC-2 gene in our country.Our results reinforce the importance of molecular surveillance to identify reservoirs and to warn about the spread of new international clones in patients carrying carbapenemases.