Drug resistance phenotypes and genotypes in Mexico in representative gram-negative species: Results from the infivar network

Abstract

Abstract Aim: This report presents phenotypic and genetic data on the prevalence and characteristics of extended-spectrum -lactamases (ESBLs) and representative carbapenemases-producing Gram-negative species in Mexico.

Material and methods: A total of 52 centers participated, 43 hospital-based laboratories and 9 external laboratories. The distribution of antimicrobial resistance data for Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, Acinetobacter baumannii complex, and Pseudomonas aeruginosa in selected clinical specimens from January 1 to March 31, 2020 was analyzed using the WHONET 5.6 platform. The following clinical isolates recovered from selected specimens were included: carbapenem-resistant Enterobacteriaceae, ESBL or carbapenem-resistant E. coli, and K. pneumoniae, carbapenem-resistant A. baumannii complex, and P. aeruginosa. Strains were genotyped to detect ESBL andor carbapenemase-encoding genes.

Results: Among blood isolates, A. baumannii complex showed more than 68 resistance for all antibiotics tested, and among Enterobacteria, E. cloacae complex showed higher resistance to carbapenems. A. baumannii complex showed a higher resistance pattern for respiratory specimens, with only amikacin having a resistance lower than 70. Among K. pneumoniae isolates, blaTEM, blaSHV, and blaCTX were detected in 68.79, 72.3, and 91.9 of isolates, respectively. Among E. coli isolates, blaTEM, blaSHV, and blaCTX were detected in 20.8, 4.53, and 85.7 isolates, respectively. For both species, the most frequent genotype was blaCTX-M-15. Among Enterobacteriaceae, the most frequently detected carbapenemase-encoding gene was blaNDM-1 (81.5), followed by blaOXA-232 (14.8) and blaoxa-181(7.4), in A. baumannii was blaOXA-24 (76) and in P. aeruginosa, was blaIMP (25.3), followed by blaGES and blaVIM (13.1 each).

Conclusion: Our study reports that NDM-1 is the most frequent carbapenemase-encoding gene in Mexico in Enterobacteriaceae with the circulation of the oxacillinase genes 181 and 232. KPC, in contrast to other countries in Latin America and the USA, is a rare occurrence. Additionally, a high circulation of ESBL blaCTX-M-15 exists in both E. coli and K. pneumoniae.