Analysis of Antimicrobial Resistance Genes (ARGs) in Enterobacterales and <i>A. baumannii</i> Clinical Strains Colonizing a Single Italian Patient

• Main Authors: Alessandra Piccirilli (Author), Elisa Meroni (Author), Carola Mauri (Author), Mariagrazia Perilli (Author), Sabrina Cherubini (Author), Arianna Pompilio (Author), Francesco Luzzaro (Author), Luigi Principe (Author)
• Format: Book
• Published: MDPI AG, 2023-02-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

The dramatic increase in infections caused by critically multidrug-resistant bacteria is a global health concern. In this study, we characterized the antimicrobial resistance genes (ARGs) of <i>K. pneumoniae</i>, <i>P. mirabilis</i>, <i>E. cloacae</i> and <i>A. baumannii</i> isolated from both surgical wound and rectal swab of a single Italian patient. Bacterial identification was performed by MALDI-TOF MS and the antimicrobial susceptibility was carried out by Vitek 2 system. The characterization of ARGs was performed using next-generation sequencing (NGS) methodology (MiSeq Illumina apparatus). <i>K. pneumoniae</i>, <i>P. mirabilis</i> and <i>E. cloacae</i> were resistant to most β-lactams and β-lactam/β-lactamases inhibitor combinations. <i>A. baumannii</i> strain was susceptible only to colistin. The presence of plasmids (IncN, IncR, IncFIB, ColRNAI and Col (MGD2)) was detected in all Enterobacterales but not in <i>A. baumannii</i> strain. The IncN plasmid and <i>bla</i>_NDM-1 gene were found in <i>K. pneumoniae</i>, <i>P. mirabilis</i> and <i>E. cloacae</i>, suggesting a possible transfer of this gene among the three clinical species. Conjugation experiments were performed using <i>K. pneumoniae</i> (1 isolate), <i>P. mirabilis</i> (2 isolates) and <i>E. cloacae</i> (2 isolates) as donors and <i>E. coli</i> J53 as a recipient. The <i>bla</i>_NDM-1 gene was identified by PCR analysis in all transconjugants obtained. The presence of four different bacterial species harboring resistance genes to different classes of antibiotics in a single patient substantially reduced the therapeutic options.

Item Description

10.3390/antibiotics12030439
2079-6382