Genomic Characterization of VIM and MCR Co-Producers: The First Two Clinical Cases, in Italy.
Diagnostics (Basel)
; 11(1)2021 Jan 06.
Article
em En
| MEDLINE
| ID: mdl-33418979
ABSTRACT
BACKGROUND:
the co-production of carbapenemases and mcr-genes represents a worrisome event in the treatment of Enterobacteriaceae infections. The aim of the study was to characterize the genomic features of two clinical Enterobacter cloacae complex (ECC) isolates, co-producing VIM and MCR enzymes, in Italy.METHODS:
species identification and antibiotic susceptibility profiling were performed using MALDI-TOF and broth microdilution methods, respectively. Transferability of the bla VIM- and mcr- type genes was verified through conjugation experiment. Extracted DNA was sequenced using long reads sequencing technology on the Sequel I platform (PacBio).RESULTS:
the first isolate showed clinical resistance against ertapenem yet was colistin susceptible (EUCAST 2020 breakpoints). The mcr-9.2 gene was harbored on a conjugative IncHI2 plasmid, while the bla VIM-1 determinant was harbored on a conjugative IncN plasmid. The second isolate, resistant to both carbapenems and colistin, harbored mcr-9 gene and its two component regulatory genes for increased expression on the chromosome, mcr-4.3 on non-conjugative (yet co-transferable) ColE plasmid, and bla VIM-1 on a non-conjugative IncA plasmid.CONCLUSIONS:
to our knowledge, this is the first report of co-production of VIM and MCR in ECC isolates in Italy.
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MEDLINE
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Ano de publicação:
2021
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Article