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Current status of NDM-producing Enterobacterales in Brazil: a narrative review

  • Clinical Microbiology - Review
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Abstract

New Delhi metallo-β-lactamase (NDM)-producing Enterobacterales was first detected in Brazil in 2014, in a Providencia rettgeri isolate recovered from surveillance swabs in the Southern region. Since then, an increasing number of NDM enzymes have been reported in different species. Nevertheless, comprehensive data on the current epidemiology of NDM-producing Enterobacterales in Brazil are lacking. Therefore, this study reviewed the available information on the status of NDM-producing bacteria in Brazil. The main finding was the diversity of bacteria producing NDM, including Klebsiella, Enterobacter, Morganella, Proteus, Escherichia, and Providencia. Limited data on clonality are available, but a few studies report different clonal backgrounds in NDM-producing K. pneumoniae, likely indicating local outbreaks. Over the years, a rise in the number of reported strains in different locations has been verified; however, different biases may have contributed to this finding. Therefore, a national surveillance study is warranted to identify the actual prevalence and incidence of NDM-producing Enterobacterales in Brazil and their role in patient management and outcome.

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References

  1. Centers for Disease Control and Prevention (CDC) (2013) Antibiotic resistance threats in the United States. US Dep Heal Hum Serv. 1–113. https://doi.org/10.15620/CDC:82532

  2. World Health Organization. Antibiotic resistance: multi-country public awareness survey. 2015. https://apps.who.int/iris/handle/10665/194460. Accessed 16 Jan 2022

  3. Zhou R, Fang X, Zhang J et al (2021) Impact of carbapenem resistance on mortality in patients infected with Enterobacteriaceae : a systematic review and meta-analysis. BMJ Open 11(12):e054971. https://doi.org/10.1136/bmjopen-2021-054971

    Article  PubMed  PubMed Central  Google Scholar 

  4. Castanheira M, Deshpande LM, Mendes RE, Canton R, Sader HS, Jones RN (2019) Variations in the occurrence of resistance phenotypes and carbapenemase genes among enterobacteriaceae isolates in 20 years of the SENTRY antimicrobial surveillance program. Open Forum Infect Dis 6(Suppl 1):S23–S33. https://doi.org/10.1093/ofid/ofy347

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Bush K, Bradford PA (2020) Epidemiology of β-lactamase-producing pathogens. Clin Microbiol Rev. 33(2). https://doi.org/10.1128/CMR.00047-19

  6. Bush K, Jacoby GA (2010) Updated functional classification of beta-lactamases. Antimicrob Agents Chemother 54(3):969–976. https://doi.org/10.1128/AAC.01009-09

    Article  CAS  PubMed  Google Scholar 

  7. Kumarasamy KK, Toleman MA, Walsh TR et al (2010) Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect Dis 10(9):597–602. https://doi.org/10.1016/S1473-3099(10)70143-2

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Wink PL, Martins AS, Volpato F, Zavascki AP, Barth AL (2021) Increased frequency of blaNDM in a tertiary care hospital in southern Brazil. Brazilian J Microbiol 52(1):299–301. https://doi.org/10.1007/s42770-020-00412-z

    Article  CAS  Google Scholar 

  9. Carvalho-Assef AP, Pereira PS, Albano RM et al (2013) Isolation of NDM-producing Providencia rettgeri in Brazil. J Antimicrob Chemother 68(12):2956–2957. https://doi.org/10.1093/jac/dkt298

    Article  CAS  PubMed  Google Scholar 

  10. Seemann T (2014) Prokka: rapid prokaryotic genome annotation. Bioinformatics 30(14):2068–2069. https://doi.org/10.1093/bioinformatics/btu153

    Article  CAS  PubMed  Google Scholar 

  11. Fortaleza CMCB, Padoveze MC, Kiffer CRV et al (2017) Multi-state survey of healthcare-associated infections in acute care hospitals in Brazil. J Hosp Infect 96(2):139–144. https://doi.org/10.1016/j.jhin.2017.03.024

    Article  PubMed  Google Scholar 

  12. Rossi F (2011) The challenges of antimicrobial resistance in Brazil. Clin Infect Dis 52(9):1138–1143. https://doi.org/10.1093/cid/cir120

    Article  PubMed  Google Scholar 

  13. Vivas R, Dolabella SS, Barbosa AAT, Jain S (2020) Prevalence of Klebsiella pneumoniae carbapenemase-and new delhi metallo-beta-lactamase-positive K. pneumoniae in Sergipe, Brazil, and combination therapy as a potential treatment option. Rev Soc Bras Med Trop 53:1–8. https://doi.org/10.1590/0037-8682-0064-2020

    Article  Google Scholar 

  14. Martins AF, Bail L, Ito CAS et al (2018) Antimicrobial activity of plazomicin against Enterobacteriaceae-producing carbapenemases from 50 Brazilian medical centers. Diagn Microbiol Infect Dis 90(3):228–232. https://doi.org/10.1016/j.diagmicrobio.2017.11.004

    Article  CAS  PubMed  Google Scholar 

  15. Sampaio JLM, Gales AC (2016) Antimicrobial resistance in Enterobacteriaceae in Brazil: focus on β-lactams and polymyxins. Brazilian J Microbiol 47:31–37. https://doi.org/10.1016/j.bjm.2016.10.002

    Article  CAS  Google Scholar 

  16. de Lima KO, de Lima AV, da Costa Rocha DA, Sampaio SCF, Cappellano P, Mello Sampaio JL (2021) A simple disk pre-diffusion test to predict in vitro aztreonam-avibactam activity against NDM-producing Klebsiella pneumoniae complex. J Glob Antimicrob Resist. https://doi.org/10.1016/j.jgar.2021.12.009

    Article  PubMed  Google Scholar 

  17. Pillonetto M, de Jordão RTS, Andraus GS et al (2021) The experience of implementing a national antimicrobial resistance surveillance system in Brazil. Front Public Heal 8:993. https://doi.org/10.3389/fpubh.2020.575536

    Article  Google Scholar 

  18. Raro OHF, da Silva RMC, Filho EMR et al (2020) Carbapenemase-producing Klebsiella pneumoniae from transplanted patients in Brazil: phylogeny, resistome, virulome and mobile genetic elements harboring blaKPC–2 or blaNDM–1. Front Microbiol 11(July):1–16. https://doi.org/10.3389/fmicb.2020.01563

    Article  Google Scholar 

  19. Foresto RD, Menezes LM, Nishimura LT et al (2021) Challenges of multidrug-resistant New Delhi metallo-beta-lactamase (NDM-1)-producing Enterobacteriaceae in kidney transplant patients. Brazilian J Nephrol. https://doi.org/10.1590/2175-8239-JBN-2021-0033

    Article  Google Scholar 

  20. Bes T, Nagano D, Martins R et al (2021) Bloodstream Infections caused by Klebsiella pneumoniae and Serratia marcescens isolates co-harboring NDM-1 and KPC-2. Ann Clin Microbiol Antimicrob 20(1):1–8. https://doi.org/10.1186/s12941-021-00464-5

    Article  CAS  Google Scholar 

  21. Monteiro J, Inoue FM, Lobo APT, Ibanes AS, Tufik S, Kiffer CRV (2019) A major monoclonal hospital outbreak of NDM-1-producing Klebsiella pneumoniae ST340 and the first report of ST2570 in Brazil. Infect Control Hosp Epidemiol 40(4):492–494. https://doi.org/10.1017/ice.2018.333

    Article  PubMed  Google Scholar 

  22. Aires CAM, Pereira PS, Rocha-De-Souza CM, Silveira MC, Carvalho-Assef APD, Asensi MD (2020) Population structure of KPC-2-producing Klebsiella pneumoniae isolated from surveillance rectal swabs in Brazil. Microb Drug Resist 26(6):652–660. https://doi.org/10.1089/mdr.2019.0166

    Article  CAS  PubMed  Google Scholar 

  23. Andrade LN, Curiao T, Ferreira JC et al (2011) Dissemination of blaKPC-2 by the spread of Klebsiella pneumoniae clonal complex 258 clones (ST258, ST11, ST437) and plasmids (IncFII, IncN, IncL/M) among Enterobacteriaceae species in Brazil. Antimicrob Agents Chemother 55(7):3579–3583. https://doi.org/10.1128/AAC.01783-10

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Alves PH, Boff RT, Barth AL, Martins AF (2019) Synergy of polymyxin B, tigecycline and meropenem against carbapenem-resistant Enterobacter cloacae complex isolates. Diagn Microbiol Infect Dis 94(1):81–85. https://doi.org/10.1016/j.diagmicrobio.2018.11.011

    Article  CAS  PubMed  Google Scholar 

  25. Pillonetto M, Arend L, Vespero EC et al (2014) First report of NDM-1-producing Acinetobacter baumannii sequence type 25 in Brazil. Antimicrob Agents Chemother 58(12):7592–7594. https://doi.org/10.1128/AAC.03444-14

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Rodríguez CH, Nastro M, Famiglietti A (2018) Carbapenemases in Acinetobacter baumannii. Review of their dissemination in Latin America. Rev Argent Microbiol. https://doi.org/10.1016/J.RAM.2017.10.006

    Article  PubMed  Google Scholar 

  27. Chagas TPG, Carvalho-Assef APD, Martins Aires CA, Bertocini R, Asensi MD (2015) Detection of an NDM-1-producing Acinetobacter bereziniae strain in Brazil. J Glob Antimicrob Resist 3(2):147–148. https://doi.org/10.1016/j.jgar.2015.03.005

    Article  PubMed  Google Scholar 

  28. Brazil, Agência Nacional de Vigilância Sanitária (ANVISA). Comunicado de Risco GVIMS/GGTES/ANVISA n 01/2021. Identificação de Pseudomonas aeruginosa resistente a carbapenêmicos, produtora de KPC e NDM em serviços de saúde. Technical Note

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Funding

This study was supported by the grants 2017/50333–7 and 2020/06157–2, Fundação de Amparo à Pesquisa do Estado de São Paulo; 402158/2021–0, Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). CHC has received Productivity Research Fellows from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).

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  1. Instituto Adolfo Lutz, Avenida Dr. Arnaldo, 9º Andar, 351, São Paulo, CEP 01246-902, Brazil

    Carlos Henrique CAMARGO

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  1. Carlos Henrique CAMARGO
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CHC collected and analyzed the data, and wrote and revised the manuscript.

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Correspondence to Carlos Henrique CAMARGO.

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Responsible Editor: Cristiano Gallina Moreira

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CAMARGO, C.H. Current status of NDM-producing Enterobacterales in Brazil: a narrative review. Braz J Microbiol 53, 1339–1344 (2022). https://doi.org/10.1007/s42770-022-00779-1

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  • DOI: https://doi.org/10.1007/s42770-022-00779-1

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