Rodríguez-Santiago Jonathan, Alvarado-Delgado Alejandro, Rodríguez-Medina Nadia, Garza-González Elvira, Tellez-Sosa Juan, Duarte-Zambrano Luis, Nava-Domínguez Neli, Sohlenkamp Christian, Vences-Guzmán Miguel A, López-Jácome Luis Esaú, Morfin-Otero Rayo, Rodriguez-Noriega Eduardo, Hernández-Castro Rigoberto, Mireles-Dávalos Christian, Becerril-Vargas Eduardo, Mena-Ramírez Juan Pablo, Cruz-García Edgar, Garza-Ramos Ulises
Programa de Doctorado en Ciencias Biomédicas, Universidad Nacional Autónoma de México, Cuernavaca, Morelos, México; Instituto Nacional de Salud Pública, Centro de Investigación sobre Enfermedades Infecciosas, Grupo de Investigación y Docencia en Resistencia Antimicrobiana, Cuernavaca, Morelos, México; Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Chiapas, Current affiliation. Tuxtla Gutiérrez, Chiapas, México.
Instituto Nacional de Salud Pública, Centro de Investigación sobre Enfermedades Infecciosas, Grupo de Investigación y Docencia en Resistencia Antimicrobiana, Cuernavaca, Morelos, México.
J Glob Antimicrob Resist. 2025 Jun;43:203-212. doi: 10.1016/j.jgar.2025.04.024. Epub 2025 May 5.
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.
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.
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.
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.
描述墨西哥耐黏菌素肺炎克雷伯菌复合种（ColR-KpSC）临床分离株的耐黏菌素机制，确定其分子流行病学及基因组特征。
本研究于2016年至2021年在墨西哥收集了1539株KpSC分离株。我们进行了全面分析，包括微生物学、遗传学、分子生物学和基因组学方法。
共有50株（3.25%）分离株对黏菌素耐药；其中49株（98%）为肺炎克雷伯菌，1株（2%）为准肺炎克雷伯菌。对这些耐药分离株进行全基因组测序，结果显示存在医院内和医院间传播，mgrB基因失活是主要耐药机制。部分KpSC分离株携带在墨西哥仔猪大肠杆菌中发现的质粒介导的mcr-1基因。耐黏菌素分离株中广泛存在超广谱β-内酰胺酶和NDM-1基因，1株高毒力菌株还产生超广谱β-内酰胺酶CTX-M-15。
本研究全面呈现了墨西哥ColR-KpSC的流行病学情况，突出了ColR-KpSC分离株中NDM-1碳青霉烯酶的高流行率；这与之前将NDM-1鉴定为KpSC中最普遍碳青霉烯酶的报道一致。由于缺乏治疗选择，这个问题在墨西哥尤为令人担忧。
