High prevalence of 16S rRNA methyltransferases among carbapenemase-producing Enterobacteriaceae in the UK & Ireland
Author(s)
Taylor, Emma
Sriskandan, S
Woodford, Neil
Hopkins, Katie
Type
Journal Article
Abstract
The emergence of 16S rRNA methyltransferases (16S RMTases) worldwide is a growing concern due to their ability to confer high-level resistance (MICs >256 mg/L) to all clinically-relevant aminoglycosides. As the occurrence of 16S RMTases in the United Kingdom has not been investigated to date, we screened 806 Enterobacteriaceae isolates displaying high-level aminoglycoside resistance (amikacin, gentamicin and tobramycin MICs ≥64, ≥32 and ≥32 mg/L, respectively) for 16S RMTases either by analysing whole-genome sequence (WGS) data (which were available for 449 isolates) or by PCR. A total of 94.5% (762/806) pan-aminoglycoside resistant Enterobacteriaceae were positive for one or more 16S RMTase genes; armA was the most common (340, 44.6%) followed by rmtC (146, 19.2%), rmtF (137, 18.0%), rmtB (87, 11.4%) and various two gene combinations (52, 6.8%). Most (93.4%; 712/762) 16S RMTase producers also carried acquired carbapenemase genes, with blaNDM the most common (592/712; 83.1%). Additionally, high-risk bacterial clones associated with blaNDM were identified in the subset of isolates with WGS data. These included E. coli sequence types (STs) 405 [21.8%, 19/87], 167 [20.7%, 18/87] 410 [12.6%, 11/87] and K. pneumoniae STs 14 [35.6%, 112/315], 231 [15.6%, 49/315] and 147 [10.5%, 33/315]. These accounted for 4.2% [15/358], 5.0% [18/358], 3.1% [11/358], 28.2% [101/358], 3.1% [11/358] and 7.0% [25/358] blaNDM-producing isolates, respectively. This study shows that 16S RMTases occur in the UK & Ireland and carbapenemases are particularly prevalent in 16S RMTase-producing Enterobacteriaceae. This association poses a risk to the treatment of multidrug-resistant Gram-negative infections in the clinical setting.
Date Issued
2018-08-01
Date Acceptance
2018-03-21
Citation
International Journal of Antimicrobial Agents, 2018, 52 (2), pp.278-282
ISSN
0924-8579
Publisher
Elsevier
Start Page
278
End Page
282
Journal / Book Title
International Journal of Antimicrobial Agents
Volume
52
Issue
2
Copyright Statement
© 2018 Elsevier B.V. and International Society of Chemotherapy. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor
National Institute for Health Research
National Institute for Health Research
Imperial College Healthcare NHS Trust- BRC Funding
Grant Number
HPRU-2012-10047
HPRU-2012-10047
RDA02
Subjects
Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
Microbiology
Pharmacology & Pharmacy
16S RMTase
Aminoglycoside resistance
bla(NDM)
Multiplex PCR
KLEBSIELLA-PNEUMONIAE
RESISTANT ENTEROBACTERIACEAE
AMINOGLYCOSIDE RESISTANCE
SEQUENCE TYPES
DISSEMINATION
IDENTIFICATION
METHYLASES
BLA(NDM-1)
EMERGENCE
PLASMIDS
1108 Medical Microbiology
1115 Pharmacology And Pharmaceutical Sciences
Publication Status
Published
Date Publish Online
2018-03-27