1. First case of New Delhi metallo-β-lactamase in Klebsiella pneumoniae from Ecuador: An update for South America.
- Author
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Romero-Alvarez D, Reyes J, Quezada V, Satán C, Cevallos N, Barrera S, Trueba G, Escobar LE, and Villacís JE
- Subjects
- Adult, Anti-Bacterial Agents pharmacology, Carbapenems pharmacology, Ecuador, Humans, Klebsiella pneumoniae drug effects, Klebsiella pneumoniae enzymology, Male, Microbial Sensitivity Tests, beta-Lactamases isolation & purification, Klebsiella Infections microbiology, Klebsiella pneumoniae genetics, Klebsiella pneumoniae isolation & purification, R Factors, beta-Lactamases genetics
- Abstract
Objectives: To describe a clinical case of Klebsiella pneumoniae harboring a New Delhi metallo-β-lactamase (NDM) plasmid in Ecuador and to present a map of reports of NDM isolates in South America., Methods: The modified Hodge test, carbapenem inactivation method, imipenem-EDTA disk method (synergy), and Rapidec Carba NP test were used to identify antibiotic resistance mechanisms. The presence of resistance genes was explored with a conjugation assay, and molecular confirmation of NDM was performed by PCR and DNA sequencing. Plasmid characterization was conducted by PCR-based replicon typing. A literature review was performed in Google Scholar and PubMed to identify reports from South America., Results: An HIV-infected patient, who had never traveled abroad, developed a bloodstream infection caused by K. pneumoniae ST147 harboring the NDM-1 resistance gene in a plasmid from the IncA/C group. Local circulation of NDM has also been described in other South American countries, in particular in Colombia and Brazil, although published scientific records were not found for other countries., Conclusions: This report presents the first evidence of autochthonous circulation of the NDM-1 resistance gene harbored by an IncA/C plasmid isolated from a K. pneumoniae ST147 in Ecuador. Efforts should be implemented to monitor and characterize the spatial and temporal distribution of NDM in Ecuador and other countries of South America., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2017
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