Genome-Based Epidemiologic Analysis of VIM/IMP Carbapenemase-Producing Enterobacter spp., Poland

Emerg Infect Dis. 2023 Aug;29(8):1618-1626. doi: 10.3201/eid2908.230199.

Abstract

We sequenced all nonduplicate 934 VIM/IMP carbapenemase-producing Enterobacterales (CPE) reported in Poland during 2006-2019 and found ≈40% of the isolates (n = 375) were Enterobacter spp. During the study period, incidence of those bacteria gradually grew in nearly the entire country. The major factor affecting the increase was clonal spread of several E. hormaechei lineages responsible for multiregional and interregional outbreaks (≈64% of all isolates), representing mainly the pandemic sequence type (ST) 90 or the internationally rare ST89 and ST121 clones. Three main VIM-encoding integron types efficiently disseminated across the clone variants (subclones) with various molecular platforms. Those variants were predominantly Pseudomonas aeruginosa-derived In238-like elements, present with IncHI2+HI2A, IncFII+FIA, IncFIB, or IncN3 plasmids, or chromosomal genomic islands in 30 Enterobacter STs. Another prevalent type, found in 34 STs, were In916-like elements, spreading in Europe recently with a lineage of IncA-like plasmids.

Keywords: E. hormaechei; Enterobacter; Enterobacterales; Poland; ST89; ST90; VIM; antimicrobial resistance; bacteria.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents
  • Bacterial Proteins / genetics
  • Carbapenem-Resistant Enterobacteriaceae*
  • Enterobacter / genetics
  • Enterobacteriaceae Infections* / epidemiology
  • Enterobacteriaceae Infections* / microbiology
  • Humans
  • Microbial Sensitivity Tests
  • Plasmids
  • Poland / epidemiology
  • beta-Lactamases / genetics

Substances

  • carbapenemase
  • Anti-Bacterial Agents
  • beta-Lactamases
  • Bacterial Proteins