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Dissemination of Verona Integron-encoded Metallo-β-lactamase among clinical and environmental Enterobacteriaceae isolates in Ontario, Canada

Philipp Kohler, Nathalie Tijet, Hyunjin C Kim, Jennie Johnstone, Tom Edge, Samir N Patel, Christine Seah, Barbara Willey, Brenda Coleman, Karen Green, Irene Armstrong, Kevin Katz, Matthew P Muller, Jeff Powis, Susan M Poutanen, David Richardson, Alicia Sarabia, Andrew Simor, Allison McGeer, Roberto G Melano & Toronto Invasive Bacterial Diseases Network (TIBDN)

abstract Surveillance data from Southern Ontario show that a majority of Verona Integron-encoded Metallo-β-lactamase (VIM)-producing Enterobacteriaceae are locally acquired. To better understand the local epidemiology, we analysed clinical and environmental bla-positive Enterobacteriaceae from the area. Clinical samples were collected within the Toronto Invasive Bacterial Diseases Network (2010-2016); environmental water samples were collected in 2015. We gathered patient information on place of residence and hospital admissions prior to the diagnosis. Patients with and without plausible source of acquisition were compared regarding risk exposures. Microbiological isolates underwent whole-genome sequencing (WGS); bla carrying plasmids were characterized. We identified 15 patients, thereof 11 with bla-positive Enterobacter hormaechei within two genetic clusters based on WGS. Whereas no obvious epidemiologic link was identified among cluster I patients, those in cluster II were connected to a hospital outbreak. Except for patients with probable acquisition abroad, we did not identify any further risk exposures. Two bla-positive E. hormaechei from environmental waters matched with the clinical clusters; plasmid sequencing suggested a common ancestor plasmid for the two clusters. These data show that both clonal spread and horizontal gene transfer are drivers of the dissemination of bla-carrying Enterobacter hormaechei in hospitals and the aquatic environment in Southern Ontario, Canada.
   
citation Kohler P, Tijet N, Kim H C, Johnstone J, Edge T, Patel S N, Seah C, Willey B, Coleman B, Green K, Armstrong I, Katz K, Muller M P, Powis J, Poutanen S M, Richardson D, Sarabia A, Simor A, McGeer A, Melano R G, Toronto Invasive Bacterial Diseases Network (TIBDN) . Dissemination of Verona Integron-encoded Metallo-β-lactamase among clinical and environmental Enterobacteriaceae isolates in Ontario, Canada. Sci Rep 2020; 10:18580.
   
type journal paper/review (English)
date of publishing 29-10-2020
journal title Sci Rep (10/1)
ISSN electronic 2045-2322
pages 18580
PubMed 33122675
DOI 10.1038/s41598-020-75247-7