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Hidden dissemination of carbapenem-susceptible OXA-48-producing Proteus mirabilis

Investigation published in The Journal of Antimicrobial Chemotherapy

August 16th, 2022

Objectives: To detect a potential hidden dissemination of the blaOXA-48 gene among Proteus mirabilis isolates obtained from a single centre.
Methods: P. mirabilis from diverse clinical samples presenting an ESBL phenotype or obtained from blood cultured from 2017 to 2019 were evaluated. Bacterial identification was performed using MALDI-TOF MS. MICs were determined using International Organization for Standardization (ISO) standard microdilution and interpreted following EUCAST guidelines. WGS was performed using both short- and long-read technologies and assemblies were done using Unicycler. Resistomes were assessed using the ResFinder database. SNPs were detected using the PATRIC bioinformatics platform. Cloning experiments were performed using the pCRII-TOPO cloning kit.
Results: Thirty-one out of 108 (28.7%) isolates were positive for blaOXA-48 and blaCTX-M-15. Twenty-nine out of 31 of the isolates were susceptible to temocillin, piperacillin/tazobactam, ertapenem and meropenem, whereas only 2/31 showed a resistance phenotype against these antibiotics. Both blaOXA-48 and blaCTX-M-15 genes were detected within the same chromosomally integrated new transposon in all isolates. The resistant isolates displayed a single mutation located in the putative promoter upstream of blaOXA-48. Cloning experiments confirmed that the mutation was responsible for the resistance phenotype.
Conclusions: The presence of a chromosomal copy of blaOXA-48 did not confer resistance to carbapenems, but a single mutation in the promoter could lead to an increase in resistance. This study shows a hidden circulation of OXA-48-positive, but carbapenem- and piperacillin/tazobactam-susceptible, P. mirabilis isolates that can become resistant to β-lactams after a single mutation




Pedraza R., Kieffer N., Guzman-Puche J., Artacho MJ., Pitart C., Hernandez-Garcia M., Vila J., Canton R. and Martinez-Martinez L.




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Hidden dissemination of carbapenem-susceptible OXA-48-producing Proteus mirabilis

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Hidden dissemination of carbapenem-susceptible OXA-48-producing Proteus mirabilis



Participants:

Universidad de CórdobaHospital Universitario Reina Sofía de Córdoba. Universidad de Córdoba (UCO).

Instituto Maimonides de Investigación Biomédica de CordobaInstituto Maimonides de Investigación Biomédica de Cordoba.

Universidad ComplutenseCentro de Vigilancia Sanitaria Veterinaria (VISAVET). Universidad Complutense (UCM).

Universidad ComplutenseDepartamento de Sanidad Animal. Facultad de Veterinaria. Universidad Complutense (UCM).

Instituto de Salud Carlos IIIRed Española de Investigación en Patología Infecciosa (REIPI). Instituto de Salud Carlos III (ISCIII).

Instituto de Salud Carlos IIICentro de Investigación de Enfermedades Infecciosas (CIBERINFEC). Instituto de Salud Carlos III (ISCIII).

Universitat de BarcelonaHospital Clínic. Universitat de Barcelona (UB).

Comunidad de MadridHospital Universitario Ramón y Cajal. Salud Madrid. Comunidad de Madrid.







The Journal of Antimicrobial Chemotherapy
FACTOR YEAR Q
5.758 2021

NLMID: 7513617

PMID: 35971566

ISSN: 0305-7453



TITLE: Hidden dissemination of carbapenem-susceptible OXA-48-producing Proteus mirabilis


JOURNAL: J. Antimicrob. Chemother.


NUMERACIÓN: dkac267


AÑO: 2022


PUBLISHER: Oxford University Press


AUTHORS: Pedraza R., Kieffer N., Guzman-Puche J., Artacho MJ., Pitart C., Hernandez-Garcia M., Vila J., Canton R. and Martinez-Martinez L.


DOI: https://doi.org/10.1093/jac/dkac267


CITE THIS PUBLICATION:

Pedraza R., Kieffer N., Guzman-Puche J., Artacho MJ., Pitart C., Hernandez-Garcia M., Vila J., Canton R. and Martinez-Martinez L. Hidden dissemination of carbapenem-susceptible OXA-48-producing Proteus mirabilis. The Journal of Antimicrobial Chemotherapy. dkac267. 2022. (A). ISSN: 0305-7453. DOI: 10.1093/jac/dkac267