Drug resistance phenotypes and genotypes in Mexico in representative gram-negative species: Results from the infivar network

Elvira Garza-González, Paola Bocanegra-Ibarias, Miriam Bobadilla-Del-Valle, Luis Alfredo Ponce-De-León-Garduño, Verónica Esteban-Kenel, Jesus Silva-Sánchez, Ulises Garza-Ramos, Humberto Barrios-Camacho, Luis Esaú López-Jácome, Claudia A. Colin-Castro, Rafael Franco-Cendejas, Samantha Flores-Treviño, Rayo Morfín-Otero, Fabian Rojas-Larios, Juan Pablo Mena-Ramírez, María Guadalupe Fong-Camargo, Cecilia Teresita Morales-De-la-Peña, Lourdes García-Mendoza, Elena Victoria Choy-Chang, Laura Karina Aviles-BenitezJosé Manuel Feliciano-Guzmán, Eduardo López-Gutiérrez, Mariana Gil-Veloz, Juan Manuel Barajas-Magallón, Efren Aguirre-Burciaga, Laura Isabel López-Moreno, Rebeca Thelma Martínez-Villarreal, Jorge Luis Canizales-Oviedo, Carlos Miguel Cetina-Umaña, Daniel Romero-Romero, Fidencio David Bello-Pazos, Nicolás Rogelio Eric Barlandas-Rendón, Joyarib Yanelli Maldonado-Anicacio, Enrique Bolado-Martínez, Mario Galindo-Méndez, Talia Perez-Vicelis, Norma Alavez-Ramírez, Braulio J. Méndez-Sotelo, Juan Francisco Cabriales-Zavala, Yirla Citlali Nava-Pacheco, Martha Irene Moreno-Méndez, Ricardo García-Romo, Aldo Rafael Silva-Gamiño, Ana María Avalos-Aguilera, María Asunción Santiago-Calderón, Maribel López-García, María del Consuelo Velázquez-Acosta, Dulce Isabel Cobos-Canul, María del Rosario Vázquez-Larios, Ana Elizabeth Ortiz-Porcayo, Arely Elizabeth Guerrero-Núñez, Jazmín Valero-Guzmán, Alina Aracely Rosales-García, Heidy Leticia Ostos-Cantú, Adrián Camacho-Ortiz

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Abstract

Aim This report presents phenotypic and genetic data on the prevalence and characteristics of extended-spectrum β-lactamases (ESBLs) and representative carbapenemases-producing Gram-negative species in Mexico. Material and methods A total of 52 centers participated, 43 hospital-based laboratories and 9 external laboratories. The distribution of antimicrobial resistance data for Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, Acinetobacter baumannii complex, and Pseudomonas aeruginosa in selected clinical specimens from January 1 to March 31, 2020 was analyzed using the WHONET 5.6 platform. The following clinical isolates recovered from selected specimens were included: carbapenem-resistant Enterobacteriaceae, ESBL or carbapenem-resistant E. coli, and K. pneumoniae, carbapenem-resistant A. baumannii complex, and P. aeruginosa. Strains were genotyped to detect ESBL and/or carbapenemase-encoding genes. Results Among blood isolates, A. baumannii complex showed more than 68% resistance for all antibiotics tested, and among Enterobacteria, E. cloacae complex showed higher resistance to carbapenems. A. baumannii complex showed a higher resistance pattern for respiratory specimens, with only amikacin having a resistance lower than 70%. Among K. pneumoniae isolates, blaTEM, blaSHV, and blaCTX were detected in 68.79%, 72.3%, and 91.9% of isolates, respectively. Among E. coli isolates, blaTEM, blaSHV, and blaCTX were detected in 20.8%, 4.53%, and 85.7% isolates, respectively. For both species, the most frequent genotype was blaCTX-M-15. Among Enterobacteriaceae, the most frequently detected carbapenemase-encoding gene was blaNDM-1 (81.5%), followed by blaOXA-232 (14.8%) and blaoxa-181(7.4%), in A. baumannii was blaOXA-24 (76%) and in P. aeruginosa, was blaIMP (25.3%), followed by blaGES and blaVIM (13.1% each). Conclusion Our study reports that NDM-1 is the most frequent carbapenemase-encoding gene in Mexico in Enterobacteriaceae with the circulation of the oxacillinase genes 181 and 232. KPC, in contrast to other countries in Latin America and the USA, is a rare occurrence. Additionally, a high circulation of ESBL blaCTX-M-15 exists in both E. coli and K. pneumoniae.

Original languageEnglish
Article numbere0248614
JournalPLoS ONE
Volume16
Issue number3 March
DOIs
StatePublished - 1 Mar 2021
Externally publishedYes

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