New Variants of Pseudomonas aeruginosa High-Risk Clone ST233 Associated with an Outbreak in a Mexican Paediatric Hospital

Author:

Aguilar-Rodea PamelaORCID,Estrada-Javier Elia L.,Jiménez-Rojas Verónica,Gomez-Ramirez UrielORCID,Nolasco-Romero Carolina G.ORCID,Rodea Gerardo E.,Rodríguez-Espino Benjamín Antonio,Mendoza-Elizalde SandraORCID,Arellano Cesar,López-Marcelino BeatrizORCID,de la Rosa Zamboni Daniela,Gamiño-Arroyo Ana Estela,Mora-Suárez Rosalia,Torres García Margarita,Franco Hernández Isabel,Parra-Ortega Israel,Campos-Valdez Guillermina,Velázquez-Guadarrama NormaORCID,Rosas-Pérez Irma

Abstract

Recent multidrug resistance in Pseudomonas aeruginosa has favoured the adaptation and dissemination of worldwide high-risk strains. In June 2018, 15 P. aeruginosa strains isolated from patients and a contaminated multi-dose meropenem vial were characterized to assess their association to an outbreak in a Mexican paediatric hospital. The strains were characterized by antibiotic susceptibility profiling, virulence factors’ production, and biofilm formation. The clonal relationship among isolates was determined with pulse-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) sequencing. Repressor genes for the MexAB-OprM efflux pump were sequenced for haplotype identification. Of the strains, 60% were profiled as extensively drug-resistant (XDR), 33% as multidrug-resistant (MDR), and 6.6% were classified as sensitive (S). All strains presented intermediate resistance to colistin, and 80% were sensitive to aztreonam. Pyoverdine was the most produced virulence factor. The PFGE technique was performed for the identification of the outbreak, revealing eight strains with the same electrophoretic pattern. ST235 and ten new sequence types (STs) were identified, all closely related to ST233. ST3241 predominated in 26.66% of the strains. Twenty-five synonymous and seventeen nonsynonymous substitutions were identified in the regulatory genes of the MexAB-OprM efflux pump, and nalC was the most variable gene. Six different haplotypes were identified. Strains from the outbreak were metallo-β-lactamases and phylogenetically related to the high-risk clone ST233.

Funder

Federal Resources of the Hospital Infantil de México Federico Gómez.

Publisher

MDPI AG

Subject

Virology,Microbiology (medical),Microbiology

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