AbuAlshaar Aseel, Piazza Aurora, Mercato Alessandra, Marchesini Federica, Mattioni Marchetti Vittoria, Bitar Ibrahim, Hrabak Jaroslav, Spalla Melissa, Pilla Giorgio, Sconfietti Renato, Migliavacca Roberta
Unit of Microbiology and Clinical Microbiology, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
Department of Microbiology, Faculty of Medicine, University Hospital in Pilsen, Charles University, Pilsen, Czechia.
Front Microbiol. 2022 Jun 9;13:920319. doi: 10.3389/fmicb.2022.920319. eCollection 2022.
The study aimed to investigate (i) the occurrence of third-generation cephalosporins and/or carbapenems non-sensitive in Pavia surface and groundwaters, (ii) their resistance determinants, and (iii) the clonal features of the most relevant strains. During May 13 and 14, 2019, = 18 water samples from = 12 sampling sites in the urban/peri-urban area of Pavia (Po Plain, Northern Italy) have been evaluated. At first, hydrochemical analysis and bacterial plate counts were carried out on all the water samples. One milliliter of each water sample was then screened on both MacConkey agar (MC) added with cefotaxime (1 mg/L; 2 mg/L) and MC plus meropenem (0.25 mg/L; 4 mg/L). Species identification and antimicrobial susceptibilities were assessed by MicroScan autoSCAN-4. Double Disk Synergy (DD) test, CT103XL microarray, S, CTX-M-/MOX-/VEB-/OXA-type genes targeted PCR and sequencing, Pulsed-Field Gel Electrophoresis (PFGE), MultiLocus Sequence Typing (MLST), and Whole-Genome Sequencing on selected strains were performed. A total of = 30 isolates grown on β-lactams enriched MC: ( = 21; 70%), spp. ( = 5; 16.6%), ( = 2; 6.7%), and ( = 2; 6.7%). All and were ESβL-producers by DD. The 66.6, 38.0, and 19.0% of were ciprofloxacin/levofloxacin, trimethoprim-sulfamethoxazole, and gentamicin resistant (EUCAST 2019 breakpoints), respectively. A CTX-M-type determinant was identified in ( = 20/21; 95.2%) and ( = 2/3; 66.7%). The remaining was VEB-1 and MOX-2 genes positive. The (6' determinant was found in = 7 and = 1 , while was found in = 1 and = 2 . PFGE showed clonal heterogeneity among ESβL-. Two out of four detected as OXA-244-positive, belonged to the pandemic ST131. One XDR from a stream sample, detected as KPC-2 positive, resulted of ST258. The epidemiological impact of OXA-244 ST131 and KPC-2 ST258 presence in surface waters of an urban area in Northern Italy must not be underestimated.
(i)帕维亚地表水和地下水中第三代头孢菌素和/或碳青霉烯类不敏感菌的出现情况;(ii)它们的耐药决定因素;(iii)最相关菌株的克隆特征。在2019年5月13日至14日期间,对来自意大利北部帕维亚市区/城郊地区(波河平原)12个采样点的18份水样进行了评估。首先,对所有水样进行了水化学分析和细菌平板计数。然后,将每份水样1毫升分别接种在添加头孢噻肟(1毫克/升;2毫克/升)的麦康凯琼脂(MC)和添加美罗培南(0.25毫克/升;4毫克/升)的MC上进行筛选。通过MicroScan autoSCAN-4评估菌种鉴定和抗菌药敏性。对选定菌株进行了双碟协同(DD)试验、CT103XL微阵列、S、CTX-M-/MOX-/VEB-/OXA型基因靶向PCR和测序、脉冲场凝胶电泳(PFGE)、多位点序列分型(MLST)以及全基因组测序。共有30株菌株在含β-内酰胺类的MC上生长:大肠埃希菌(21株;70%)、肺炎克雷伯菌(5株;16.6%)、阴沟肠杆菌(2株;6.7%)和产气肠杆菌(2株;6.7%)。所有肺炎克雷伯菌和产气肠杆菌通过DD试验鉴定为产ESβL菌。分别有66.6%、38.0%和19.0%的大肠埃希菌对环丙沙星/左氧氟沙星、甲氧苄啶-磺胺甲恶唑和庆大霉素耐药(按照2019年欧洲抗菌药物敏感性试验委员会的断点标准)。在大肠埃希菌(20/21;95.2%)和肺炎克雷伯菌(2/3;66.7%)中鉴定出CTX-M型决定簇。其余菌株为VEB-1和MOX-2基因阳性。在7株大肠埃希菌和1株肺炎克雷伯菌中发现了blaCTX-M-6'决定簇,而在1株大肠埃希菌和2株肺炎克雷伯菌中发现了blaCTX-M-15。PFGE显示产ESβL菌之间存在克隆异质性。检测为OXA-244阳性的4株肺炎克雷伯菌中有2株属于大流行的ST131。从一份溪流样本中检测出的一株XDR肺炎克雷伯菌为KPC-2阳性,属于ST258。在意大利北部一个市区的地表水中存在OXA-244 ST131和KPC-2 ST258的流行病学影响不容小觑。