Genotypic characterization and clonal relatedness of metallo-ß-lactamase-producing non-fermentative gram negative bacteria in the first 5 years of their circulation in Paraguay (2011-2015).

Pseudomonas aeruginosa and species of Acinetobacter calcoaceticus-baumanii complex are multiresistant intrahospital opportunistic pathogens, able to acquire carbapenemases and produce outbreaks with high morbidity and mortality. Pseudomonas putida has also emerged with similar characteristics. The aim of this research was to characterize the Metallo-ß-lactamases (MBLs) detected by surveillance in Paraguay in the first 5 years of their circulation in hospitals. The coexistence of KPC and OXA-type carbapenemases was also investigated. 70 MBL-producing strains from inpatients were detected from clinical samples and rectal swab from 11 hospitals. The strains were identified by manual, automated, and molecular methods. Antimicrobial susceptibility was studied by Kirby-Bauer and automated methods, while colistin susceptibility was determined by broth macrodilution. MBLs were investigated by synergy with EDTA against carbapenems and PCR, and their variants by sequencing. KPC and OXA-carbapenemases were investigated by PCR. Clonality was studied by pulsed-field gel electrophoresis (PFGE). The results demonstrated the circulation of blaVIM-2 (60%), blaNDM-1 (36%), and blaIMP-18 (4%). The MBL-producing species were P. putida (45.7%), P. aeruginosa (17.2%), A. baumannii (24.3%), A. pittii (5.7%), A. nosocomialis, (4.3%) A. haemolyticus (1.4%), and A. bereziniae (1.4%). PFGE analysis showed one dominant clone for A. baumannii, a predominant clone for half of the strains of P. aeruginosa, and a polyclonal spread for P. putida. In the first 5 years of circulation in Paraguay, MBLs were disseminated as unique variants per genotype, appeared only in Pseudomonas spp. and Acinetobacter spp., probably through horizontal transmission between species and vertical by some successful clones.

Acinetobacter calcoaceticus-Acinetobacter baumannii complex in animals: identification and antimicrobial resistance profile / Complexo Acinetobacter calcoaceticus-Acinetobacter baumannii em animais: identificação e perfil de resistência antimicrobiana

Acinetobacter spp. is emerging as an important human and veterinary pathogen, mostly due to intrinsic and acquired resistance to antimicrobials. Despite its public health relevance, little is known about the prevalence, role of different Acinetobacter species and antimicrobial resistance profile of animal-origin isolates. Traditional phenotypic tests may fail to discriminate Acinetobacter species, therefore molecular analyses are often required as a complementary approach. The objectives of this study were to evaluate the occurrence of strains of the Acinetobacter calcoaceticus-Acinetobacter baumannii (Acb) complex isolated from animal infections including urinary tract infections, otitis, piodermitis and pododermatitis, and its resistance profile against different antimicrobial classes, including carbapenems. All Gram-negative coccobacilli isolates were characterized by MALDI-TOF and multiplex PCR, and the disk diffusion test was used to investigate multi-drug resistance (MDR) and carbapenem resistance genes by PCR as preconized by the standard guidelines. MALDI-TOF technique identified 21 strains belonging to the Acb complex (10 A. pittii, 8 A. baumannii, 3 A. nosocomialis, 1 A. ursingii, and 1 A. venetianus). Multiplex PCR confirmed the results of MALDI-TOF for 20 strains. Eight strains (34.78%) were classified as MDR, being 50% (4/8) A. baumannii, 37.5% (3/8) A. pittii, and 12.5% (1/8) A. nosocomialis. None of the isolates presented phenotypic carbapenemase production. Considering the carbapenem resistance genes, 26.09% (6/23) of the isolates presented one or more carbapenemase genes. From these, 50% (3/6) presented only bla VIM, 33.33% (2/6) presented only blaIMP, and 16.67% (1/6) presented blaIMP e blaVIM, simultaneously. These genes were detected among A. pittii isolates mostly (66.67%, 4/6). This study provides further insights into the occurrence and resistance profile of Acinetobacter of animal origin.

Acinetobacter spp. está emergindo como um importante patógeno humano e veterinário, principalmente devido à resistência intrínseca e adquirida aos antimicrobianos. Apesar de sua relevância para a saúde pública, pouco se sabe sobre a prevalência, o papel das diferentes espécies de Acinetobacter e o perfil de resistência antimicrobiana de isolados de origem animal. Testes fenotípicos tradicionais podem falhar em discriminar espécies de Acinetobacter, portanto, análises moleculares são frequentemente necessárias como uma abordagem complementar. Os objetivos deste estudo foram avaliar a ocorrência de cepas do complexo Acinetobacter calcoaceticus-Acinetobacter baumannii (Acb) isolados de infecções de animais, incluindo infecções do trato urinário, otite, piodermite e pododermatite, e seu perfil de resistência a diferentes classes de antimicrobianos, incluindo os carbapenêmicos. Todas as cepas cocobacilos Gram-negativas foram caracterizados por MALDI-TOF e PCR multiplex, e o teste de difusão em disco foi usado para investigar genes de resistência a múltiplas drogas (MDR) e resistência a carbapenêmicos por PCR conforme preconizado pelas diretrizes padrão. A técnica MALDI-TOF identificou 21 cepas pertencentes ao complexo Acb (10 A. pittii, 8 A. baumannii, 3 A. nosocomialis, 1 A. ursingii e 1 A. venetianus). Multiplex PCR confirmou os resultados de MALDI-TOF para 20 cepas. Oito cepas (34.78%) foram classificadas como MDR, sendo 50% (4/8) A. baumannii, 37.5% (3/8) A. pittii e 12.5% (1/8) A. nosocomialis. Nenhum dos isolados apresentou produção fenotípica de carbapenemases. Considerando os genes de resistência a carbapenemas, 26.09% (6/23) dos isolados apresentaram um ou mais genes de carbapenemases. Destes, 50% (3/6) apresentaram apenas bla VIM, 33.33% (2/6) apresentaram apenas bla IMP e 16.67% (1/6) apresentaram bla IMP e bla VIM, simultaneamente. Esses genes foram detectados principalmente entre os isolados de A. pittii (66.67%, 4/6). Este estudo fornece mais informações sobre a ocorrência e perfil de resistência de Acinetobacter de origem animal.

Genomic characterization of an extensively drug-resistant KPC-2-producing Klebsiella pneumoniae ST855 (CC258) only susceptible to ceftazidime-avibactam isolated in Brazil.

In this study, we describe the genetic features of an XDR KPC-2-producing Klebsiella pneumoniae isolate by using whole-genome sequencing, its clinical-epidemiological context and susceptibility against antimicrobial combinations. The isolate belongs to clonal complex 258 and harbors several acquired genes and mutations associated with antimicrobial resistance.

Early detection of OXA-370-producing Klebsiella pneumoniae ST17 co-harboring blaCTX-M-8 in Brazil.

We aimed to describe an early detection of OXA-370-producing Klebsiella pneumoniae in Brazil. The isolate CCBH10079 belonged to ST17 and the blaOXA-370 was located in a plasmid of ≅57kb.

Lectin-binding properties of Aeromonas caviae strains / Propriedades lectínicas de amostras de Aeromonas caviae

The cell surface carbohydrates of four strains of Aeromonas caviae were analyzed by agglutination and lectin-binding assays employing twenty highly purified lectins encompassing all sugar specificities. With the exception of L-fucose and sialic acid, the sugar residues were detected in A. caviae strains. A marked difference, however, in the pattern of cell surface carbohydrates in different A. caviae isolates was observed. Specific receptors for Tritricum vulgaris (WGA), Lycopersicon esculentum (LEL) and Solanum tuberosum (STA) (D-GlcNAc-binding lectins) were found only in ATCC 15468 strain, whereas Euonymus europaeus (EEL, D-Gal-binding lectin) sites were present exclusively in AeQ32 strain, those for Helix pomatia (HPA, D-GalNAc-binding lectin) in AeC398 and AeV11 strains, and for Canavalia ensiformes (Con A, D-Man-binding lectin) in ATCC 15468, AeC398, AeQ32 and AeV11 strains, after bacterial growing at 37ºC. On the other hand, specific receptors for WGA and EEL were completely abrogated growing the bacteria at 22ºC. Binding studies with 125I- labeled lectins from WGA, EEL and Con A were performed. These assays essentially confirmed the selectivity, demonstrated in the agglutination assays of these lectins for the A. caviae strains.

Os carboidratos de superfície celular de quatro amostras de Aeromonas caviae foram analisados por aglutinação e ensaios de ligação de lectinas empregando vinte lectinas altamente purificadas com especificidade para açúcares. Com exceção da L-fucose e do ácido siálico, os resíduos de açúcar foram detectados em amostras de A. caviae. Entretanto, foi observada uma diferença marcante no padrão de carboidratos de superfície celular em diferentes amostras de A. caviae. Receptores específicos para Tritricum vulgaris (WGA), Lycopersicon esculentum (LEL) e Solanum tuberosum (STA), lectinas de ligação a D-GlcNAc, foram encontrados apenas na amostra ATCC 15468, enquanto sítios de Euonymus europaes (EEL), lectina de ligação a D-Gal, estavam presentes exclusivamente na amostra AeQ32, sítios de Helix pomatia (HPA), lectina de ligação a D-GalNac, nas amostras AeC398 e AeV11 e de Canavalia ensiformis (Com A), lectina de ligação a D-Man, nas amostras ATCC 15468, AeC398, AeQ32 e AeV11, após crescimento bacteriano a 37ºC. Por outro lado, receptores específicos para WGA e EEL foram completamente abolidos após o crescimento das bactérias a 22ºC. Estudos de ligação com lectinas WGA, EEL e Con A marcadas com 125I também foram realizados. Esses ensaios confirmaram a seletividade, demonstrada em ensaios de aglutinação dessas lectinas para as amostras de A. caviae.

Lectin-binding properties of Aeromonas caviae strains.

The cell surface carbohydrates of four strains of Aeromonas caviae were analyzed by agglutination and lectin-binding assays employing twenty highly purified lectins encompassing all sugar specificities. With the exception of L-fucose and sialic acid, the sugar residues were detected in A. caviae strains. A marked difference, however, in the pattern of cell surface carbohydrates in different A. caviae isolates was observed. Specific receptors for Tritricum vulgaris (WGA), Lycopersicon esculentum (LEL) and Solanum tuberosum (STA) (D-GlcNAc-binding lectins) were found only in ATCC 15468 strain, whereas Euonymus europaeus (EEL, D-Gal-binding lectin) sites were present exclusively in AeQ32 strain, those for Helix pomatia (HPA, D-GalNAc-binding lectin) in AeC398 and AeV11 strains, and for Canavalia ensiformes (Con A, D-Man-binding lectin) in ATCC 15468, AeC398, AeQ32 and AeV11 strains, after bacterial growing at 37°C. On the other hand, specific receptors for WGA and EEL were completely abrogated growing the bacteria at 22°C. Binding studies with (125)I- labeled lectins from WGA, EEL and Con A were performed. These assays essentially confirmed the selectivity, demonstrated in the agglutination assays of these lectins for the A. caviae strains.

Patterns of adherence to HEp-2 cells and actin polymerisation by toxigenic Corynebacterium diphtheriae strains.

Corynebacterium diphtheriae strains displayed different degrees of attachment to HEp-2 cell monolayers with two distinct adherence patterns, termed localised (LA) and diffuse (DA). The LA phenotype predominated over the DA phenotype. The non-sucrose fermenting strains expressing DA pattern adhered mostly with high index values (> or =10bact/cell). Low adhesion index (<10bact/cell) was mainly observed among sucrose fermenting strains. The fluorescein isothiocyanate (FITC)-labelled phalloidin assay (fluorescent-actin staining test) showed positive results for microorganisms of both LA and DA phenotypes. The FITC-labelled C. diphtheriae non-fimbrial surface proteins 67-72p interacted directly with HEp-2 cell membranes. Therefore, toxigenic C. diphtheriae exhibited LA and DA adherence patterns and ability to induce actin polymerisation. The experimental evidences also pointed to 67-72p as putative adhesins of C. diphtheriae to HEp-2 cells.

Influence of polarisation and differentiation on interaction of 43-kDa outer-membrane protein of Aeromonas caviae with human enterocyte-like Caco-2 cell line.

It has been recognised that adherence and invasion to host cells are important steps in the pathogenesis of entero-pathogenic bacteria, including Aeromonas caviae. However, the virulence factors of A. caviae remain, for the most part, poorly known. This study examined the interaction of A. caviae isolates to Caco-2 cells in different polarisation and differentiation conditions. The adherence of A. caviae may be related to accessibility of host cell basolateral receptors. Aggregative A. caviae isolates, grown at 22 degrees C, were more adherent in both non-polarised and undifferentiated Caco-2 cells and EGTA-treated polarised and differentiated Caco-2 cells. Furthermore, monolayers pre-incubated with 43-kDa outer-membrane protein (OMP) or A. caviae strains pre-incubated with rabbit IgG anti-43-kDa OMP decreased adherence of some A. caviae strains to EGTA-treated polarised and differentiated Caco-2 cells, suggesting an interaction of 43-kDa OMP with basolateral cell receptors. Bacterial cells were observed adhering to microvilli and to plasma membrane on both the apical and basal surfaces of the monolayer. Pedestal-like formation with cytoskeletal rearrangement was also observed. The bacteria entered the Caco-2 cells and were observed enclosed in single and multiple membrane-bound vacuoles within the host cell cytoplasm. Furthermore, A. caviae were observed free in the cytosol of Caco-2 cells, suggesting escape form cytoplasmatic vacuoles.