Article
Author: Cruz-García, Edgar ; Alvarado-Delgado, Alejandro ; Rodríguez-Medina, Nadia ; Morfin-Otero, Rayo ; Duarte-Zambrano, Luis ; Hernández-Castro, Rigoberto ; Becerril-Vargas, Eduardo ; Garza-González, Elvira ; Nava-Domínguez, Neli ; Vences-Guzmán, Miguel A ; López-Jácome, Luis Esaú ; Sohlenkamp, Christian ; Tellez-Sosa, Juan ; Rodriguez-Noriega, Eduardo ; Garza-Ramos, Ulises ; Mena-Ramírez, Juan Pablo ; Mireles-Dávalos, Christian ; Rodríguez-Santiago, Jonathan
OBJECTIVE:Characterize the colistin-resistance mechanisms, determine the molecular epidemiology, and genomic traits of the colistin-resistant Klebsiella pneumoniae species complex (ColR-KpSC) clinical isolates in Mexico.
METHODS:In this study, 1539 KpSC isolates were collected in Mexico from 2016 to 2021. We conducted a comprehensive analysis that included microbiological, genetic, molecular, and genomic approaches.
RESULTS:A total of 50 isolates (3.25%) were colistin-resistant; of which 49 (98%) corresponded to K. pneumoniae and 1 (2%) to Klebsiella quasipneumoniae. Whole genome sequencing of these resistant isolates revealed intra- and inter-hospital dissemination, and the mgrB inactivation was the main resistance mechanism. Some KpSC isolates carried plasmid-borne mcr-1 gene found in Escherichia coli from piglets in Mexico. The colistin-resistant isolates presented a high prevalence of extended-spectrum β-lactamases- and NDM-1 genes, and one hypervirulent strain also produced extended-spectrum β-lactamases CTX-M-15.
CONCLUSIONS:This study provides a comprehensive snapshot of the epidemiology of ColR-KpSC in Mexico, highlighting a high prevalence of NDM-1 carbapenemase among ColR-KpSC isolates; this is in line with previous reports identifying NDM-1 as the most prevalent carbapenemase in KpSC. This problem is particularly concerning in Mexico because of the lack of therapeutic options.