Genomic data reveals the emergence of the co-occurrence of blaKPC-2 and blaCTX-M-15 in an E. coli ST648 strain isolated from rectal swab within the framework of hospital surveillance.

PIEKAR MARIA; ALVAREZ VERONICA; QUIROGA MARIA PAULA; CENTRON DANIELA

J Glob Antimicrob Resist

Elsevier Science BV

Lugar: Amsterdam; Año: 2023

2213-7165

Objectives: The worldwide dissemination of carbapenemase-producing Escherichia coli lineages belonging to high-risk clones poses a challenging public health menace. The aim of this work was to investigate genomic features of a colonizing multidrug resistant strain of KPC-producing E. coli from our institution. Methods: WGS was done by Illumina MiSeq-I, and de novo assembly was achieved using SPAdes. Resistome, mobilome, plasmids, virulome, and integrons were analyzed using Resfinder, AMRFinder, ISFinder, PlasmidFinder, mob-suite, VirulenceFinder and IntegronFinder. Sequence types (STs) were identified with pubMLST and BIGSdb databases. Conjugation assays were also performed. Results: E. coli HA25pEc was isolated from a rectal swab sample taken within the framework of the hospital epidemiological surveillance protocol for detection of carbapenemase-producing Enterobacterales. E. coli HA25pEc corresponded to the first report of ST648 co-harboring blaKPC-2 and blaCTX-M-15 in Latin America from a colonized patient. It had 19 antibiotic resistance genes (ARG) including blaKPC-2 located on a Tn4401a isoform. Conjugation assays revealed that the blaKPC-2 was not transferred by conjugation to E. coli J53 under our experimental conditions.Conclusions: E. coli ST648 has been detected previously in companion and farm animals as well as in hospital- and community-acquired infections worldwide. Although scarcely reported as KPC-producer, our finding in a culture surveillance with several acquired ARG including blaCTX-M-15, alerts the potential of this clone for worldwide unnoticed spreading of extreme drug resistance to β-lactams. This data reinforces the importance of carrying out molecular surveillance to identify reservoirs and warn about the dissemination of new international clones in carbapenemase-bearing patients.