Melgarejo Touchet Nancy, Weiler Natalie, Busignani Sofía, Orrego Verónica, Duarte María José, Martínez Jazmin, Dunjo Pamela, Martínez Mora Mario, Kawabata Aníbal, Irala Juan, Brítez Mariel, Escobar Federico, Gonzalez Fátima, Riquelme Carmen, Soilan Beatriz
Laboratorio Central de Salud Pública, Asunción, Paraguay.
Hospital del Trauma "Dr. Manuel Giani", Asunción, Paraguay.
Rev Peru Med Exp Salud Publica. 2025 Aug 25;42(2):138-146. doi: 10.17843/rpmesp.2025.422.14293.
Motivation for the study. To generate knowledge about the current situation of antimicrobial resistance in Enterobacteriaceae using whole genome sequencing. Main findings. This study presents the first genome sequencing of double-carbapenemase-producing Enterobacteriaceae from patients with extended hospital stays in Paraguay. Of the seven double-carbapenemase-producing Enterobacteriaceae isolates, six were Klebsiella subsp pneumoniae. Implications. Our findings highlight the urgent need to strengthen measures to prevent and control healthcareassociated infections in order to prevent the spread of these highly resistant bacteria.
OBJECTIVES.: To describe the whole genome sequencing of double-carbapenemase-producing Enterobacteriaceae isolates circulating in Paraguay.
MATERIALS AND METHODS.: We conducted genomic studies on seven Enterobacteriaceae isolates, previously confirmed as double-carbapenemase producers by PCR, from patients with extended hospital stays and broad-spectrum antimicrobial treatment in seven hospitals in Paraguay. Genome sequencing included Unicycler assembly and multilocus sequence typing (MLST).
RESULTS.: Of the seven Enterobacterales isolates producing dual carbapenemases, six were Klebsiella pneumoniae subsp. pneumoniae and one was Enterobacter cloacae subsp. cloacae. The co-production of bla KPC-2/bla NDM-1 and bla KPC-2/bla NDM-5 was confirmed in K. pneumoniae. We found co-production of bla NDM-1/bla OXA-163 in E. cloacae, along with other antimicrobial resistance genes of chromosomal and plasmid origin. The MLST sequence types of the K. pneumoniae isolates were ST11, ST15, ST133, ST273, and ST1303, and that of E. cloacae was ST976. Two of the six K. pneumoniae ST11 isolates, from two different hospitals in the capital, were genetically related and both carried bla KPC-2 and bla NDM-5.
CONCLUSIONS.: We report the first genome sequencing of double-carbapenemase-producing Enterobacterales from patients with extended hospital stays in Paraguay. The analysis revealed diverse resistance profiles and clones, carriage of multiple carbapenemases, and other resistance genes of chromosomal and plasmid origin. These findings emphasize the need to strengthen hospital infection control and implement effective therapeutic interventions.
Motivation for the study. To generate knowledge about the current situation of antimicrobial resistance in Enterobacteriaceae using whole genome sequencing. Main findings. This study presents the first genome sequencing of double-carbapenemase-producing Enterobacteriaceae from patients with extended hospital stays in Paraguay. Of the seven double-carbapenemase-producing Enterobacteriaceae isolates, six were Klebsiella subsp pneumoniae. Implications. Our findings highlight the urgent need to strengthen measures to prevent and control healthcareassociated infections in order to prevent the spread of these highly resistant bacteria.
研究动机。利用全基因组测序了解肠杆菌科细菌的抗菌药物耐药现状。主要发现。本研究展示了巴拉圭住院时间延长患者中产生双碳青霉烯酶的肠杆菌科细菌的首次基因组测序。在7株产生双碳青霉烯酶的肠杆菌科细菌分离株中，6株为肺炎克雷伯菌亚种。意义。我们的发现凸显了迫切需要加强措施以预防和控制医疗相关感染，从而防止这些高度耐药细菌的传播。
描述在巴拉圭传播的产生双碳青霉烯酶的肠杆菌科细菌分离株的全基因组测序情况。
我们对来自巴拉圭7家医院中住院时间延长且接受广谱抗菌治疗的患者的7株肠杆菌科细菌分离株进行了基因组研究，这些分离株先前经聚合酶链反应确认为双碳青霉烯酶产生菌。基因组测序包括Unicycler组装和多位点序列分型（MLST）。
在7株产生双碳青霉烯酶的肠杆菌科细菌分离株中，6株为肺炎克雷伯菌亚种肺炎克雷伯菌，1株为阴沟肠杆菌亚种阴沟肠杆菌。在肺炎克雷伯菌中证实了bla KPC - 2/bla NDM - 1和bla KPC - 2/bla NDM - 5的共同产生。我们在阴沟肠杆菌中发现了bla NDM - 1/bla OXA - 163的共同产生，以及其他染色体和质粒来源的抗菌药物耐药基因。肺炎克雷伯菌分离株的MLST序列型为ST11、ST15、ST133、ST273和ST1303，阴沟肠杆菌的为ST976。来自首都两家不同医院的6株肺炎克雷伯菌ST11分离株中的两株在基因上相关，且均携带bla KPC - 2和bla NDM - 5。
我们报告了巴拉圭住院时间延长患者中产生双碳青霉烯酶的肠杆菌科细菌的首次基因组测序。分析揭示了不同的耐药谱和克隆、多种碳青霉烯酶的携带情况以及其他染色体和质粒来源的耐药基因。这些发现强调了加强医院感染控制和实施有效治疗干预措施的必要性。
研究动机。利用全基因组测序了解肠杆菌科细菌的抗菌药物耐药现状。主要发现。本研究展示了巴拉圭住院时间延长患者中产生双碳青霉烯酶的肠杆菌科细菌的首次基因组测序。在7株产生双碳青霉烯酶的肠杆菌科细菌分离株中，6株为肺炎克雷伯菌亚种。意义。我们的发现凸显了迫切需要加强措施以预防和控制医疗相关感染，从而防止这些高度耐药细菌的传播。
