FRI-2 carbapenemase-producing Enterobacter cloacae complex in the UK
      
      
        
      
      
      
      
        
          
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Meunier, Danièle
Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health, England, London, UK
          
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Findlay, Jacqueline
Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health, England, London, UK
          
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Doumith, Michel
Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health, England, London, UK
          
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Godoy, Daniel
Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health, England, London, UK
          
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Perry, Claire
Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health, England, London, UK
          
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Pike, Rachel
Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health, England, London, UK
          
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Gronthoud, Firza
Department of Microbiology, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
          
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Shryane, Theresa
Public Health England North West, Manchester, UK
          
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Poirel, Laurent
  Emerging Antibiotic Resistance Unit, Medical and Molecular Microbiology, Department of Medicine, Faculty of Science, University of Fribourg, Switzerland - INSERM European Unit, LEA, Paris, France
          
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Welfare, William
Public Health England North West, Manchester, UK
          
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Woodford, Neil
Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health, England, London, UK
          
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Hopkins, Katie L.
Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health, England, London, UK
          
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        Published in:
        
          
            
            - Journal of Antimicrobial Chemotherapy. - 2017, vol. 72, no. 9, p. 2478–2482
 
       
      
      
      
       
      
      
      
        
        English
        
        
        
          Objectives: Detection of rarer carbapenemases is challenging, as it requires molecular  assays with comprehensive coverage or the use of phenotypic methods for the  detection of carbapenemase activity. We describe a new class A carbapenemase,  FRI-2, in an Enterobacter cloacae complex isolate following implementation of an in-  house multiplex PCR for the detection of ‘rare’ class A carbapenemases.Methods:  MICs were determined by agar dilution. A carbapenem-resistant E. cloacae complex  isolate was tested by PCR for the class A carbapenemases blaKPC, blaFRI, blaIMI,  blaGES and blaSME. Carbapenemase activity was assessed using Carba NP and the  carbapenem inactivation method. Whole genome and plasmid analyses of the clinical  isolate and the FRI-2 transformant were performed by WGS, respectively. Typing was  carried out by PFGE.Results: The E. cloacae complex isolate showed resistance to  imipenem (MIC = 16 mg/L), meropenem (MIC = 8 mg/L) and ertapenem (MIC = 8   mg/L), but remained susceptible to piperacillin/tazobactam (MIC = 8 mg/L).  Carbapenemase activity was confirmed in the isolate by both phenotypic methods. A  blaFRI-1-like gene was detected by PCR and analysis of WGS data of the clinical  isolate identified an ORF of 885 bp, which showed 97% nucleotide identity with  blaFRI-1 and was named blaFRI-2. WGS of the transformant indicated blaFRI-2 was  located on a 108 kb IncF/IncR plasmid. The FRI-2-positive E. cloacae complex isolate  belonged to a novel ST (ST829).ConclusionsThe possible circulation of rarer  carbapenemases in clinical settings highlights the role of phenotypic tests to detect  carbapenemase activity when molecular assays are negative for the ‘big 5’  carbapenemase families.
        
        
       
      
      
      
        
        
        
        
        
        
        
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- Faculté des sciences et de médecine
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- Médecine 3ème année
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                  Biological sciences
                
              
            
          
        
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          Persistent URL
        
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          https://folia.unifr.ch/unifr/documents/306130
        
 
   
  
  
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