Characteristics of rare ST463 carbapenem-resistant Pseudomonas aeruginosa clinical isolates from blood

Xiaodong Zhang; Miran Tang; Ye Xu; Mengxin Xu; Changrui Qian; Xiangkuo Zheng; Tieli Zhou; Qing Wu

doi:10.1016/j.jgar.2023.01.011

Characteristics of rare ST463 carbapenem-resistant Pseudomonas aeruginosa clinical isolates from blood

J Glob Antimicrob Resist. 2023 Mar:32:122-130. doi: 10.1016/j.jgar.2023.01.011. Epub 2023 Feb 16.

Authors

Xiaodong Zhang¹, Miran Tang¹, Ye Xu², Mengxin Xu¹, Changrui Qian³, Xiangkuo Zheng¹, Tieli Zhou⁴, Qing Wu⁵

Affiliations

¹ Department of Clinical Laboratory, the First Affiliated Hospital of Wenzhou Medical University, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, Wenzhou, China.
² Department of Clinical Laboratory, Fifth Affiliated Hospital, Southern Medical University, Guangzhou, China.
³ School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, China.
⁴ Department of Clinical Laboratory, the First Affiliated Hospital of Wenzhou Medical University, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, Wenzhou, China. Electronic address: wyztli@163.com.
⁵ Department of Clinical Laboratory, the First Affiliated Hospital of Wenzhou Medical University, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, Wenzhou, China. Electronic address: wuqing830@163.com.

PMID: 36801256
DOI: 10.1016/j.jgar.2023.01.011

Abstract

Objectives: This study aimed to elucidate resistance to carbapenems and fluoroquinolones, the transmission mechanism of bla_KPC-2, and the virulence characteristics of a Pseudomonas aeruginosa strain (TL3773) isolated in East China.

Methods: The virulence and resistance mechanisms of TL3773 were investigated by whole genome sequencing (WGS), comparative genomic analysis, conjugation experiments, and virulence assays.

Results: This study isolated carbapenem-resistant P. aeruginosa from blood resistant to carbapenems. The patient's clinical data showed poor prognosis compounded by multiple sites of infection. WGS showed that TL3773 carried aph (3')-IIb, bla_PAO, bla_OXA-486, fosA, catB7, and two crpP resistance genes on chromosome, and the carbapenem resistance gene bla_KPC-2 on plasmid. We identified a novel crpP gene named TL3773-crpP2. Cloning experiments proved that TL3773-crpP2 was not the primary cause of fluoroquinolone resistance in TL3773. GyrA and ParC mutations may confer fluoroquinolone resistance. The bla_KPC-2 genetic environment was IS26-TnpR-ISKpn27-bla_KPC-2-ISKpn6-IS26-Tn3-IS26, potentially mediating the transmission of bla_KPC-2 in P. aeruginosa. The overall virulence of TL3773 was lower than that of PAO1. However, the pyocyanin and biofilm formation of TL3773 was higher than that of PAO1. WGS further indicated that TL3773 was less virulent than PAO1. Phylogenetic analysis showed that TL3773 was most similar to the P. aeruginosa isolate ZYPA29 from Hangzhou, China. These observations further indicate that ST463 P. aeruginosa is rapidly spreading.

Conclusions: The threat of ST463 P. aeruginosa harbouring bla_KPC-2 is emergent and may pose a threat to human health. More extensive surveillance and effective actions are urgently needed to control its further spread.

Keywords: Carbapenem-resistant Pseudomonas aeruginosa; ST463; Virulence; bla(KPC-2); bla(OXA-486); crpP.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anti-Bacterial Agents* / pharmacology
Carbapenems / pharmacology
Fluoroquinolones / pharmacology
Humans
Phylogeny
Pseudomonas aeruginosa*
beta-Lactamases / genetics

Substances

Anti-Bacterial Agents
beta-Lactamases
Carbapenems
Fluoroquinolones