First Report in the Americas of <i>S. enterica</i> Var. Enteritidis Carrying <i>bla</i><sub>NDM-1</sub> in a Putatively New Sub-Lineage of IncC2 Plasmids

Background: Infections caused by carbapenem-resistant Enterobacterales have steadily multiplied over time, becoming a major threat to healthcare systems due to limited therapeutic options and high case-fatality rates. Case report: We studied a patient who, after being discharged from an ICU, develop...

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Main Authors: Nicolás F. Cordeiro, Romina Papa-Ezdra, Germán Traglia, Inés Bado, Virginia García-Fulgueiras, María N. Cortinas, Leticia Caiata, Mariana López-Vega, Ana Otero, Martín López, Patricia Hitateguy, Cristina Mogdasy, Rafael Vignoli
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Language:English
Published: MDPI AG 2025-06-01
Series:Antibiotics
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Online Access:https://www.mdpi.com/2079-6382/14/6/620
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author Nicolás F. Cordeiro
Romina Papa-Ezdra
Germán Traglia
Inés Bado
Virginia García-Fulgueiras
María N. Cortinas
Leticia Caiata
Mariana López-Vega
Ana Otero
Martín López
Patricia Hitateguy
Cristina Mogdasy
Rafael Vignoli
author_facet Nicolás F. Cordeiro
Romina Papa-Ezdra
Germán Traglia
Inés Bado
Virginia García-Fulgueiras
María N. Cortinas
Leticia Caiata
Mariana López-Vega
Ana Otero
Martín López
Patricia Hitateguy
Cristina Mogdasy
Rafael Vignoli
author_sort Nicolás F. Cordeiro
collection DOAJ
description Background: Infections caused by carbapenem-resistant Enterobacterales have steadily multiplied over time, becoming a major threat to healthcare systems due to limited therapeutic options and high case-fatality rates. Case report: We studied a patient who, after being discharged from an ICU, developed salmonellosis caused by an antibiotic-susceptible <i>S. enteritidis</i>. After undergoing treatment with ciprofloxacin, the patient presented an episode of asymptomatic bacteriuria originated by a carbapenem and ciprofloxacin-resistant <i>S. enteritidis</i>. Results: Whole genome sequencing analysis revealed that both <i>Salmonella</i> isolates belonged to the same strain, and that isolate SEn_T2 acquired a plasmid carrying both <i>bla</i><sub>NDM-1</sub> and <i>qnrA1</i> genes (pIncCSEn) which was previously present in the patient’s gut in at least one <i>Enterobacter cloacae</i> isolate. Additionally, pIncCSEN was identified as a putatively new sub-lineage of IncC2 plasmids which lacked the first copy of the methyltransferase gene <i>dcm</i> and the <i>rhs</i> gene. The resistance genes <i>bla</i><sub>NDM-1</sub> and <i>qnrA1</i> were incorporated into a Tn<i>21</i>-derived transposon that included a complex class 1 integron whose genetic arrangement was: <i>intI1</i>- <i>dfrA12</i>- <i>orfF</i>- <i>aadA2</i>- <i>qacEΔ1</i>-<i>sul1</i>-IS<i>CR1</i>- <i>trpF</i>- <i>ble</i>- <i>bla</i><sub>NDM-1</sub> (in reverse direction)- IS<i>Aba125</i>-IS<i>CR1</i>- <i>qnrA</i>- <i>cmlA1</i>- <i>qacEΔ1</i>-<i>sul1</i>. Conclusions: Antimicrobial persistence and co-selection of antibiotic resistance play an important role in the dissemination of antimicrobial resistance genes; in this regard, a joint effort involving the infection control team, effective antibiotic stewardship, and genomic surveillance could help mitigate the spread of these multidrug resistant microorganisms.
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spelling doaj-art-83be3037cff34b0c94a7ecfdebfa59292025-08-20T03:26:15ZengMDPI AGAntibiotics2079-63822025-06-0114662010.3390/antibiotics14060620First Report in the Americas of <i>S. enterica</i> Var. Enteritidis Carrying <i>bla</i><sub>NDM-1</sub> in a Putatively New Sub-Lineage of IncC2 PlasmidsNicolás F. Cordeiro0Romina Papa-Ezdra1Germán Traglia2Inés Bado3Virginia García-Fulgueiras4María N. Cortinas5Leticia Caiata6Mariana López-Vega7Ana Otero8Martín López9Patricia Hitateguy10Cristina Mogdasy11Rafael Vignoli12Unidad Académica de Bacteriología y Virología, Instituto de Higiene, Facultad de Medicina, Av. Alfredo Navarro 3051, Montevideo 11600, UruguayUnidad Académica de Bacteriología y Virología, Instituto de Higiene, Facultad de Medicina, Av. Alfredo Navarro 3051, Montevideo 11600, UruguayUnidad de Genómica y Bioinformática, Departamento de Ciencias Biológicas, CENUR Litoral Norte, Universidad de la República, Salto 50000, UruguayUnidad Académica de Bacteriología y Virología, Instituto de Higiene, Facultad de Medicina, Av. Alfredo Navarro 3051, Montevideo 11600, UruguayUnidad Académica de Bacteriología y Virología, Instituto de Higiene, Facultad de Medicina, Av. Alfredo Navarro 3051, Montevideo 11600, UruguayDepartamentos de Laboratorios de Salud Pública, Ministerio de Salud Pública, Montevideo 11600, UruguayDepartamentos de Laboratorios de Salud Pública, Ministerio de Salud Pública, Montevideo 11600, UruguayDepartamentos de Laboratorios de Salud Pública, Ministerio de Salud Pública, Montevideo 11600, UruguayDepartamentos de Laboratorios de Salud Pública, Ministerio de Salud Pública, Montevideo 11600, UruguaySanatorio Círculo Católico, Montevideo 11800, UruguaySanatorio Círculo Católico, Montevideo 11800, UruguayDepartamentos de Laboratorios de Salud Pública, Ministerio de Salud Pública, Montevideo 11600, UruguayUnidad Académica de Bacteriología y Virología, Instituto de Higiene, Facultad de Medicina, Av. Alfredo Navarro 3051, Montevideo 11600, UruguayBackground: Infections caused by carbapenem-resistant Enterobacterales have steadily multiplied over time, becoming a major threat to healthcare systems due to limited therapeutic options and high case-fatality rates. Case report: We studied a patient who, after being discharged from an ICU, developed salmonellosis caused by an antibiotic-susceptible <i>S. enteritidis</i>. After undergoing treatment with ciprofloxacin, the patient presented an episode of asymptomatic bacteriuria originated by a carbapenem and ciprofloxacin-resistant <i>S. enteritidis</i>. Results: Whole genome sequencing analysis revealed that both <i>Salmonella</i> isolates belonged to the same strain, and that isolate SEn_T2 acquired a plasmid carrying both <i>bla</i><sub>NDM-1</sub> and <i>qnrA1</i> genes (pIncCSEn) which was previously present in the patient’s gut in at least one <i>Enterobacter cloacae</i> isolate. Additionally, pIncCSEN was identified as a putatively new sub-lineage of IncC2 plasmids which lacked the first copy of the methyltransferase gene <i>dcm</i> and the <i>rhs</i> gene. The resistance genes <i>bla</i><sub>NDM-1</sub> and <i>qnrA1</i> were incorporated into a Tn<i>21</i>-derived transposon that included a complex class 1 integron whose genetic arrangement was: <i>intI1</i>- <i>dfrA12</i>- <i>orfF</i>- <i>aadA2</i>- <i>qacEΔ1</i>-<i>sul1</i>-IS<i>CR1</i>- <i>trpF</i>- <i>ble</i>- <i>bla</i><sub>NDM-1</sub> (in reverse direction)- IS<i>Aba125</i>-IS<i>CR1</i>- <i>qnrA</i>- <i>cmlA1</i>- <i>qacEΔ1</i>-<i>sul1</i>. Conclusions: Antimicrobial persistence and co-selection of antibiotic resistance play an important role in the dissemination of antimicrobial resistance genes; in this regard, a joint effort involving the infection control team, effective antibiotic stewardship, and genomic surveillance could help mitigate the spread of these multidrug resistant microorganisms.https://www.mdpi.com/2079-6382/14/6/620carbapenemasesantimicrobial resistanceNDM-1<i>Salmonella enterica</i>transposon
spellingShingle Nicolás F. Cordeiro
Romina Papa-Ezdra
Germán Traglia
Inés Bado
Virginia García-Fulgueiras
María N. Cortinas
Leticia Caiata
Mariana López-Vega
Ana Otero
Martín López
Patricia Hitateguy
Cristina Mogdasy
Rafael Vignoli
First Report in the Americas of <i>S. enterica</i> Var. Enteritidis Carrying <i>bla</i><sub>NDM-1</sub> in a Putatively New Sub-Lineage of IncC2 Plasmids
Antibiotics
carbapenemases
antimicrobial resistance
NDM-1
<i>Salmonella enterica</i>
transposon
title First Report in the Americas of <i>S. enterica</i> Var. Enteritidis Carrying <i>bla</i><sub>NDM-1</sub> in a Putatively New Sub-Lineage of IncC2 Plasmids
title_full First Report in the Americas of <i>S. enterica</i> Var. Enteritidis Carrying <i>bla</i><sub>NDM-1</sub> in a Putatively New Sub-Lineage of IncC2 Plasmids
title_fullStr First Report in the Americas of <i>S. enterica</i> Var. Enteritidis Carrying <i>bla</i><sub>NDM-1</sub> in a Putatively New Sub-Lineage of IncC2 Plasmids
title_full_unstemmed First Report in the Americas of <i>S. enterica</i> Var. Enteritidis Carrying <i>bla</i><sub>NDM-1</sub> in a Putatively New Sub-Lineage of IncC2 Plasmids
title_short First Report in the Americas of <i>S. enterica</i> Var. Enteritidis Carrying <i>bla</i><sub>NDM-1</sub> in a Putatively New Sub-Lineage of IncC2 Plasmids
title_sort first report in the americas of i s enterica i var enteritidis carrying i bla i sub ndm 1 sub in a putatively new sub lineage of incc2 plasmids
topic carbapenemases
antimicrobial resistance
NDM-1
<i>Salmonella enterica</i>
transposon
url https://www.mdpi.com/2079-6382/14/6/620
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