Double-carbapenemase-producing Enterobacteriaceae: complete genome sequencing of isolates from hospitals in Paraguay, 2021
DOI:
https://doi.org/10.17843/rpmesp.2025.422.14293Keywords:
Klebsiella pneumoniae, Enterobacter cloacae, carbapenem resistance, dual production of carbapenemases, Whole genome sequencing, Illumina Miseq, ParaguayAbstract
Objectives. To describe the whole genome sequencing of double-carbapenemase-producing Enterobacteriaceae isolates circulating in Paraguay. Materials and methods. We conducted genomic studies on seven Enterobacteriaceae isolates, previously confirmed as double-carbapenemase producers by PCR, from patients with extended hospital stays and broad- spectrum antimicrobial treatment in seven hospitals in Paraguay. Genome sequencing included Unicycler assembly and multilocus sequence typing (MLST). Results. Of the seven Enterobacterales isolates producing dual carbapenemases, six were Klebsiella pneumoniae subsp. pneumoniae and one was Enterobacter cloacae subsp. cloacae. The co-production of blaKPC-2/blaNDM-1 and blaKPC-2/blaNDM-5 was confirmed in K. pneumoniae. We found co-production of blaNDM-1/blaOXA-163 in E. cloacae, along with other antimicrobial resistance genes of chromosomal and plasmid origin. The MLST sequence types of the K. pneumoniae isolates were ST11, ST15, ST133, ST273, and ST1303, and that of E. cloacae was ST976. Two of the six K. pneumoniae ST11 isolates, from two different hospitals in the capital, were genetically related and both carried blaKPC-2 and blaNDM-5. Conclusions. We report the first genome sequencing of double-carbapenemase-producing Enterobacterales from patients with extended hospital stays in Paraguay. The analysis revealed diverse resistance profiles and clones, carriage of multiple carbapenemases, and other resistance genes of chromosomal and plasmid origin. These findings emphasize the need to strengthen hospital infection control and implement effective therapeutic interventions.
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Copyright (c) 2025 Nancy Melgarejo Touchet, Natalie Weiler, Sofía Busignani, Verónica Orrego, María José Duarte, Jazmin Martínez, Pamela Dunjo, Mario Martínez Mora, Aníbal Kawabata, Juan Irala, Mariel Brítez, Federico Escobar, Fátima Gonzalez, Carmen Riquelme; Beatriz Soilan
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