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Multispecies emergence of dual blaKPC/NDM carbapenemase-producing Enterobacterales recovered from invasive infections in Chile

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dc.contributor.authorQuesille, Ana
dc.contributor.authorSolar, Camila
dc.contributor.authorMartínez, Jose
dc.contributor.authorRivas Jiménez, Lina María
dc.contributor.authorQuiroz, Valeria
dc.contributor.authorGonzález, Ana
dc.contributor.authorRiquelme, Roberto
dc.contributor.authorUgalde, Juan
dc.contributor.authorPeters, Anne
dc.contributor.authorOrtega, Oscar
dc.contributor.authorAraos Bralic, Rafael Ignacio
dc.contributor.authorGarcía, Patricia
dc.contributor.authorLebreton, Francois
dc.contributor.authorMunita, Jose M.
dc.contributor.authorDiaz, Lorena
dc.date.accessioned2026-08-12T15:38:16Z
dc.date.available2026-08-12T15:38:16Z
dc.date.issued2025
dc.description.abstractCarbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) represent a significant global threat. The emergence of dual CP-CRE is particularly alarming, as they can potentially compromise the efficacy of newer antibiotics, further decreasing therapeutic alternatives. Herein, we report the emergence of multiple species of CP-CRE recovered from invasive infections in Chile that simultaneously harbor blaKPC and blaNDM and provide an in-depth genomic characterization of these worrisome pathogens. We collected carbapenem-resistant Enterobacterales (CRE) isolates from invasive infections over a 4-year period, across 11 healthcare centers in Chile. Bacterial species and the presence of carbapenemase genes were confirmed using MALDI-TOF and PCR assays, respectively. Antimicrobial susceptibility testing was conducted through disk diffusion and broth microdilution methods. Dual CP-CRE isolates were subjected to short- and long-read whole genome sequencing to perform a detailed genomic characterization of the isolates and of the mobile genetic elements harboring the enzymes. From a total of 1,335 CRE isolates, we observed an increase in the prevalence of CP-CRE, from 11% in 2019 to 38% in 2022. A total of 11 dual CP-CRE isolates were recovered, all of them harboring blaKPC and blaNDM. Species corresponded to Escherichia coli (n = 6), Klebsiella pneumoniae (n = 2), Klebsiella oxytoca (n = 2), and Citrobacter freundii (n = 1). Dual CP-CRE isolates exhibited resistance to all tested β-lactams except for cefiderocol. The blaKPC and blaNDM encoding genes were located on independent plasmids. Platforms harboring blaKPC were diverse and included IncN, IncF, and IncFIB plasmids. In contrast, blaNDM-7 was only found on fairly conserved IncX3 plasmids. We report that a rapid increase of CP-CRE in Chile, alongside with the emergence of multiple bacterial species of CP-CRE co-harboring blaKPC-2/3 and blaNDM-7, underscores a critical public health challenge. Our data suggest that the dissemination of blaNDM-7 was predominantly facilitated by IncX3 plasmids, whereas the spread of blaKPC involved multiple plasmid backbones. Active surveillance and genomic monitoring are critical to inform public policy and curtail the spread of these highly resistant pathogens.
dc.description.versionVersión Publicada
dc.identifier.citationQuesille-Villalobos AM, Solar C, Martínez JRW, Rivas L, Quiroz V, González AM, Riquelme-Neira R, Ugalde JA, Peters A, Ortega-Recalde O, Araos R, García P, Lebreton F, Munita JM, Diaz L. Multispecies emergence of dual blaKPC/NDM carbapenemase-producing Enterobacterales recovered from invasive infections in Chile. Antimicrob Agents Chemother. 2025 Jan 31;69(1):e0120524. doi: 10.1128/aac.01205-24
dc.identifier.doihttps://doi.org/10.1128/aac.01205-24
dc.identifier.urihttps://hdl.handle.net/11447/11001
dc.language.isoen
dc.subjectEnterobacterales
dc.subjectantibiotic resistance
dc.subjectcarbapenem-resistant Enterobacterales
dc.subjectdual carbapenemase-producing CRE
dc.titleMultispecies emergence of dual blaKPC/NDM carbapenemase-producing Enterobacterales recovered from invasive infections in Chile
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceAntimicrobial agents and chemotherapy
dspace.entity.typePublication
relation.isAuthorOfPublication2bf16b44-04d3-45fe-8dd0-dafa6322ca94
relation.isAuthorOfPublication69e40056-7a55-41b3-8a65-05aace0e07e3
relation.isAuthorOfPublicationec52b0bf-d0bc-4844-9531-eca4a65f2b8e
relation.isAuthorOfPublication.latestForDiscovery2bf16b44-04d3-45fe-8dd0-dafa6322ca94

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