2020/01/01 by Alessandra Bielli, Aurora Piazza, Valeria Cento +7 · 4 citations
Biochemistry, Genetics and Molecular Biology · Medicine · #Antibiotic Resistance in Bacteria #Antibiotic resistance #Antibiotics #Antimicrobial Resistance in Staphylococcus #Bacterial biofilms and quorum sensing #Biology #Carbapenem #Escherichia coli #Gene #Genetics #Internal medicine #Klebsiella pneumoniae #Medicine #Microbiology #Plasmid #Pneumonia #Respiratory system #Respiratory tract infections #Serratia marcescens #Transmission (telecommunications) #Virology
paper · doi:10.1099/jmm.0.001113
openalex publication_date 2020/01/01 · openalex created_date 2020/01/10 · openalex updated_date 2026/07/25
In recent years, Serratia marcescens has emerged as an important agent of hospital-acquired infections, such as pneumonia, urinary tract infection, septicaemia and meningitis, particularly in vulnerable patients. Compared to Klebsiella pneumoniae and Escherichia coli , S. marcescens is less commonly associated with bla KPC genes, yet few cases of plasmid transmission at the gastrointestinal level from K. pneumoniae carbapenemase (KPC)-producing Enterobacterales to S. marcescens have been described. Here we report a case of in vivo acquisition, during a 3-month period of hospitalization in the intensive care unit, of a bla KPC-3 gene carried by a pKpQIL-IT plasmid, and its probable transmission at the bronchial level among different species of Enterobacterales , including K. pneumoniae and S. marcescens . By using whole genome sequence analyses we were able provide insight into the dynamics of carbapenem-resistance determinants acquisition in the lower respiratory tract, a novel anatomical region for such plasmid transmission events, that usually involve the gastrointestinal tract. The co-presence at the same time of both wild-type and resistant Enterobacterales could have been the critical factor leading to the spread of plasmids harbouring carbapenem-resistance genes, of particular importance during surveillance screenings. The possibility of such an event may have significant consequences in terms of antimicrobial treatment, with a potential limitation of therapeutic options, thereby further complicating the clinical management of high-risk critically ill patients.