Please use this identifier to cite or link to this item:http://hdl.handle.net/20.500.12105/7248
Carbapenem-resistant Citrobacter spp. isolated in Spain from 2013 to 2015 produced a variety of carbapenemases including VIM-1, OXA-48, KPC-2, NDM-1 and VIM-2
Arana, David M | Ortega, Adriana ISCIII | González-Barberá, Eva | Lara Fuella, Noelia ISCIII | Bautista, Verónica ISCIII | Gómez-Ruíz, Dolores | Saez, David ISCIII | Fernández-Romero, Sara ISCIII | Aracil, Belen ISCIII | Perez-Vazquez, Maria Dolores ISCIII | Campos, Jose ISCIII | Oteo-Iglesias, Jesus ISCIII | Spanish Antibiotic Resistance Surveillance Programme Collaborating Group
J Antimicrob Chemother. 2017 Dec 1;72(12):3283-3287.
Objectives: There is little information about carbapenemase-producing (CP) Citrobacter spp. We studied the molecular epidemiology and microbiological features of CP Citrobacter spp. isolates collected in Spain (2013-15). Methods: In total, 119 isolates suspected of being CP by the EUCAST screening cut-off values were analysed. Carbapenemases and ESBLs were characterized using PCR and sequencing. The genetic relationship among Citrobacter freundii isolates was studied by PFGE. Results: Of the 119 isolates, 63 (52.9%) produced carbapenemases, of which 37 (58.7%) produced VIM-1, 20 (31.7%) produced OXA-48, 12 (19%) produced KPC-2, 2 (3.2%) produced NDM-1 and 1 (1.6%) produced VIM-2; 9 C. freundii isolates co-produced VIM-1 plus OXA-48. Fourteen isolates (22.2%) also carried ESBLs: 8 CTX-M-9 plus SHV-12, 2 CTX-M-9, 2 SHV-12 and 2 CTX-M-15. Fifty-seven isolates (90.5%) were C. freundii, 4 (6.3%) were Citrobacter koseri, 1 (1.6%) was Citrobacter amalonaticus and 1 (1.6%) was Citrobacter braakii. By EUCAST breakpoints, eight (12.7%) of the CP isolates were susceptible to the four carbapenems tested. In the 53 CP C. freundii analysed by PFGE, a total of 44 different band patterns were observed. Four PFGE clusters were identified: cluster 1 included eight isolates co-producing VIM-1 and OXA-48; blaVIM-1 was carried in a class 1 integron (intI-blaVIM-1-aacA4-dfrB1-aadA1-catB2-qacEΔ1/sul1) and blaOXA-48 was carried in a Tn1999.2 transposon. Conclusions: We observed the clonal and polyclonal spread of CP Citrobacter spp. across several Spanish geographical areas. Four species of Citrobacter spp. produced up to five carbapenemase types, including co-production of VIM-1 plus OXA-48. Some CP Citrobacter spp. isolates were susceptible to the four carbapenems tested, a finding with potential clinical implications.
Bacterial Proteins | Carbapenem-Resistant Enterobacteriaceae | Citrobacter | Electrophoresis, Gel, Pulsed-Field | Enterobacteriaceae Infections | Genotype | Humans | Molecular Epidemiology | Molecular Typing | Polymerase Chain Reaction | Sequence Analysis, DNA | Spain | beta-Lactamases | Genetic Variation
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