First Report in the Americas of <i>S. enterica</i> Var. Enteritidis Carrying <i>bla</i><sub>NDM-1</sub> in a Putatively New Sub-Lineage of IncC2 Plasmids

First Report in the Americas of <i>S. enterica</i> Var. Enteritidis Carrying <i>bla</i><sub>NDM-1</sub> in a Putatively New Sub-Lineage of IncC2 Plasmids

Background: Infections caused by carbapenem-resistant Enterobacterales have steadily multiplied over time, becoming a major threat to healthcare systems due to limited therapeutic options and high case-fatality rates. Case report: We studied a patient who, after being discharged from an ICU, develop...

Full description

Saved in:
Bibliographic Details
Main Authors: Nicolás F. Cordeiro, Romina Papa-Ezdra, Germán Traglia, Inés Bado, Virginia García-Fulgueiras, María N. Cortinas, Leticia Caiata, Mariana López-Vega, Ana Otero, Martín López, Patricia Hitateguy, Cristina Mogdasy, Rafael Vignoli
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Antibiotics
Subjects:
carbapenemases
antimicrobial resistance
NDM-1
<i>Salmonella enterica</i>
transposon
Online Access:https://www.mdpi.com/2079-6382/14/6/620
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: Infections caused by carbapenem-resistant Enterobacterales have steadily multiplied over time, becoming a major threat to healthcare systems due to limited therapeutic options and high case-fatality rates. Case report: We studied a patient who, after being discharged from an ICU, developed salmonellosis caused by an antibiotic-susceptible <i>S. enteritidis</i>. After undergoing treatment with ciprofloxacin, the patient presented an episode of asymptomatic bacteriuria originated by a carbapenem and ciprofloxacin-resistant <i>S. enteritidis</i>. Results: Whole genome sequencing analysis revealed that both <i>Salmonella</i> isolates belonged to the same strain, and that isolate SEn_T2 acquired a plasmid carrying both <i>bla</i><sub>NDM-1</sub> and <i>qnrA1</i> genes (pIncCSEn) which was previously present in the patient’s gut in at least one <i>Enterobacter cloacae</i> isolate. Additionally, pIncCSEN was identified as a putatively new sub-lineage of IncC2 plasmids which lacked the first copy of the methyltransferase gene <i>dcm</i> and the <i>rhs</i> gene. The resistance genes <i>bla</i><sub>NDM-1</sub> and <i>qnrA1</i> were incorporated into a Tn<i>21</i>-derived transposon that included a complex class 1 integron whose genetic arrangement was: <i>intI1</i>- <i>dfrA12</i>- <i>orfF</i>- <i>aadA2</i>- <i>qacEΔ1</i>-<i>sul1</i>-IS<i>CR1</i>- <i>trpF</i>- <i>ble</i>- <i>bla</i><sub>NDM-1</sub> (in reverse direction)- IS<i>Aba125</i>-IS<i>CR1</i>- <i>qnrA</i>- <i>cmlA1</i>- <i>qacEΔ1</i>-<i>sul1</i>. Conclusions: Antimicrobial persistence and co-selection of antibiotic resistance play an important role in the dissemination of antimicrobial resistance genes; in this regard, a joint effort involving the infection control team, effective antibiotic stewardship, and genomic surveillance could help mitigate the spread of these multidrug resistant microorganisms.
ISSN:2079-6382

Similar Items