Comparative in vitro activity of plazomicin and older aminoglyosides against Enterobacterales isolates; prevalence of aminoglycoside modifying enzymes and 16S rRNA methyltransferases.

Atividade *in vitro* comparativa da plazomicina e de aminoglicosídeos mais antigos contra isolados de Enterobacterales; prevalência de enzimas modificadoras de aminoglicosídeos e metiltransferases do RNAr 16S.

Plazomisin ve eski aminoglikozitlerin Enterobacterales izolatlarına karşı karşılaştırmalı in vitro aktivitesi; aminoglikozit modifiye edici enzimlerin ve 16S rRNA metiltransferazların prevalansı.

Clicks: 391
ID: 108104
2020
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Abstract
Comparative in vitro activity of plazomicin and 4 older aminoglycosides was evaluated with broth microdilution in 714 blood isolates from 14 hospitals in Turkey. Isolates included Escherichia coli (n=320), Klebsiella spp. (n=294), Enterobacter spp. (n=69), Serratia marcescens (n=20), and Citrobacter spp. (n=11). Isolates resistant to older aminoglycosides (n=240) were screened for aminoglycoside modifying enzyme genes: aac(6')-Ib, aac(3)-Ia, aac(3)-IIa, ant(2″)-Ia. Isolates with high MICs for plazomicin (n=41) were screened for 16S rRNA methyltransferase genes (armA, rmtA, rmtB, rmtC, rmtD, rmtE, rmtF, rmtG, rmtH, npmA) and 2 carbapenemase genes (blaOXA-48, blaNDM-1). Overall, resistance to plazomicin, amikacin, netilmicin, gentamicin, and tobramycin was 7.7%, 7.4%, 31.5%, 32.9%, and 34.7%, respectively. aac(6')-Ib and aac(3)-IIa were the most common AME genes. Co-occurrence of blaNDM-1 with armA and rmtC and blaOXA-48 with armA was striking. Enterobacter cloacae carrying rmtC+blaNDM-1, S. marcescens with armA+blaOXA-48, and rmtF+ blaOXA-48 in K. pneumoniae were reported for the first time.
A atividade comparativa in vitro da plazomicina e de 4 aminoglicosídeos mais antigos foi avaliada por microdiluição em caldo em 714 isolados sanguíneos de 14 hospitais na Turquia. Os isolados incluíram Escherichia coli (n=320), Klebsiella spp. (n=294), Enterobacter spp. (n=69), Serratia marcescens (n=20) e Citrobacter spp. (n=11). Os isolados resistentes aos aminoglicosídeos mais antigos (n=240) foram triados para genes de enzimas modificadoras de aminoglicosídeos (AME): aac(6')-Ib, aac(3)-Ia, aac(3)-IIa, ant(2″)-Ia. Isolados com CIMs elevadas para plazomicina (n=41) foram triados para genes de 16S rRNA metiltransferases (armA, rmtA, rmtB, rmtC, rmtD, rmtE, rmtF, rmtG, rmtH, npmA) e 2 genes de carbapenemases (blaOXA-48, blaNDM-1). No geral, a resistência à plazomicina, amicacina, netilmicina, gentamicina e tobramicina foi de 7,7%, 7,4%, 31,5%, 32,9% e 34,7%, respectivamente. aac(6')-Ib e aac(3)-IIa foram os genes de AME mais comuns. A coocorrência de blaNDM-1 com armA e rmtC e de blaOXA-48 com armA foi notável. Enterobacter cloacae portando rmtC+blaNDM-1, S. marcescens com armA+blaOXA-48 e rmtF+blaOXA-48 em K. pneumoniae foram relatados pela primeira vez.
Türkiye'deki 14 hastaneden elde edilen 714 kan izolatında plazomisin ve daha eski 4 aminoglikozitin karşılaştırmalı *in vitro* aktivitesi sıvı mikrodilüsyon yöntemiyle değerlendirilmiştir. İzolatlar; *Escherichia coli* (n=320), *Klebsiella* spp. (n=294), *Enterobacter* spp. (n=69), *Serratia marcescens* (n=20) ve *Citrobacter* spp. (n=11) türlerini içermektedir. Eski aminoglikozitlere dirençli izolatlar (n=240), aminoglikozit modifiye edici enzim genleri [*aac(6')-Ib*, *aac(3)-Ia*, *aac(3)-IIa*, *ant(2″)-Ia*] açısından taranmıştır. Plazomisin için yüksek MİK değerlerine sahip izolatlar (n=41), 16S rRNA metiltransferaz genleri (*armA*, *rmtA*, *rmtB*, *rmtC*, *rmtD*, *rmtE*, *rmtF*, *rmtG*, *rmtH*, *npmA*) ve 2 karbapenemaz geni (*bla*OXA-48, *bla*NDM-1) açısından taranmıştır. Genel olarak plazomisin, amikasin, netilmisin, gentamisin ve tobramisin direnci sırasıyla %7,7, %7,4, %31,5, %32,9 ve %34,7 olarak saptanmıştır. En yaygın AME genleri *aac(6')-Ib* ve *aac(3)-IIa* olmuştur. *bla*NDM-1'in *armA* ve *rmtC* ile, *bla*OXA-48'in ise *armA* ile birlikte bulunması dikkat çekicidir. *rmtC*+*bla*NDM-1 taşıyan *Enterobacter cloacae*, *armA*+*bla*OXA-48 taşıyan *S. marcescens* ve *K. pneumoniae*'da *rmtF*+*bla*OXA-48 ilk kez bildirilmiştir.
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Authors Deniz Gür, Ufuk Hasdemir, Aslı Çakar, İffet Çavuşoğlu, Tuğçe Çelik, Burak Aksu
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Journal Diagnostic microbiology and infectious disease
Year 2020
DOI
S0732-8893(20)30469-7
URL
Keywords
E. coli aminoglycoside modifying enzyme arma klebsiella ndm-1 16s rrna methyltransferase aminoglycoside resistance enterobacter oxa-48 plazomicin serratia rmta rmtb rmtc rmte rmtf

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