A role for arthropods as vectors of multidrug-resistant Enterobacterales in surgical site infections from South Asia

Hassan, Brekhna, Ijaz, Muhammad, Khan, Asadullah, Sands, Kirsty, Serfas, Georgios Ion, Clayfield, Liam, El-Bouseary, Maisra Mohammed, Lai, Giulia, Portal, Edward, Khan, Afifah, Watkins, William J. ORCID: https://orcid.org/0000-0003-3262-6588, Parkhill, Julian and Walsh, Timothy R. ORCID: https://orcid.org/0000-0003-4315-4096 2021. A role for arthropods as vectors of multidrug-resistant Enterobacterales in surgical site infections from South Asia. Nature Microbiology 6 (10) , p. 1270. 10.1038/s41564-021-00965-1

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Abstract

Understanding how multidrug-resistant Enterobacterales (MDRE) are transmitted in low- and middle-income countries (LMICs) is critical for implementing robust policies to curb the increasing burden of antimicrobial resistance (AMR). Here, we analysed samples from surgical site infections (SSIs), hospital surfaces (HSs) and arthropods (summer and winter 2016) to investigate the incidence and transmission of MDRE in a public hospital in Pakistan. We investigated Enterobacterales containing resistance genes (blaCTX-M-15, blaNDM and blaOXA-48-like) for identification, antimicrobial susceptibility testing and whole-genome sequencing. Genotypes, phylogenetic relationships and transmission events for isolates from different sources were investigated using single-nucleotide polymorphism (SNP) analysis with a cut-off of ≤20 SNPs. Escherichia coli (14.3%), Klebsiella pneumoniae (10.9%) and Enterobacter cloacae (16.3%) were the main MDRE species isolated. The carbapenemase gene blaNDM was most commonly detected, with 15.5%, 15.1% and 13.3% of samples positive in SSIs, HSs and arthropods, respectively. SNP (≤20) and spatiotemporal analysis revealed linkages in bacteria between SSIs, HSs and arthropods supporting the One Health approach to underpin infection control policies across LMICs and control AMR.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine Biosciences
Publisher:	Nature Research
ISSN:	2058-5276
Date of First Compliant Deposit:	18 November 2021
Date of Acceptance:	19 August 2021
Last Modified:	15 Apr 2023 01:18
URI:	https://orca.cardiff.ac.uk/id/eprint/145597

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