Please use this identifier to cite or link to this item:http://hdl.handle.net/20.500.12105/15453
Carbapenemase-Producing Klebsiella pneumoniae in COVID-19 Intensive Care Patients: Identification of IncL-VIM-1 Plasmid in Previously Non-Predominant Sequence Types
Cañada-Garcia, Javier Enrique ISCIII | Ramirez de Arellano, Eva ISCIII | Jiménez-Orellana, Miguel | Viedma, Esther | Sánchez, Aida | Alhambra, Almudena | Villa, Jennifer | Delgado-Iribarren, Alberto | Bautista, Veronica ISCIII | Lara Fuella, Noelia ISCIII | García-Cobos, Silvia ISCIII | Aracil, Belen ISCIII | Cercenado, Emilia | Perez-Vazquez, Maria ISCIII | Oteo-Iglesias, Jesus ISCIII
Antibiotics (Basel). 2023 Jan 6;12(1):107.
During the COVID-19 pandemic, intensive care units (ICUs) operated at or above capacity, and the number of ICU patients coinfected by nosocomial microorganisms increased. Here, we characterize the population structure and resistance mechanisms of carbapenemase-producing Klebsiella pneumoniae (CP-Kpn) from COVID-19 ICU patients and compare them to pre-pandemic populations of CP-Kpn. We analyzed 84 CP-Kpn isolates obtained during the pandemic and 74 CP-Kpn isolates obtained during the pre-pandemic period (2019) by whole genome sequencing, core genome multilocus sequence typing, plasmid reconstruction, and antibiotic susceptibility tests. More CP-Kpn COVID-19 isolates produced OXA-48 (60/84, 71.4%) and VIM-1 (18/84, 21.4%) than KPC (8/84, 9.5%). Fewer pre-pandemic CP-Kpn isolates produced VIM-1 (7/74, 9.5%). Cefiderocol (97.3-100%) and plazomicin (97.5-100%) had the highest antibiotic activity against pandemic and pre-pandemic isolates. Sequence type 307 (ST307) was the most widely distributed ST in both groups. VIM-1-producing isolates belonging to ST307, ST17, ST321 and ST485, (STs infrequently associated to VIM-1) were detected during the COVID-19 period. Class 1 integron Int1-blaVIM-1-aac(6')-1b-dfrB1-aadAI-catB2-qacEΔ1/sul1, found on an IncL plasmid of approximately 70,000 bp, carried blaVIM-1 in ST307, ST17, ST485, and ST321 isolates. Thus, CP-Kpn populations from pandemic and pre-pandemic periods have similarities. However, VIM-1 isolates associated with atypical STs increased during the pandemic, which warrants additional monitoring and surveillance.
Klebsiella pneumoniae | Carbapenemases | COVID-19 | Antibiotic resistance | Intensive care units (ICUs) | Outbreaks | cgMLST | WGS
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