AUTHOR=Silveira Melise Chaves , Rocha-de-Souza Cláudio Marcos , de Oliveira Santos Ivson Cassiano , Pontes Leilane da Silva , Oliveira Thamirys Rachel Tavares e , Tavares-Teixeira Camila Bastos , Cossatis Nataly de Almeida , Pereira Natacha Ferreira , da Conceição-Neto Orlando Carlos , da Costa Bianca Santos , Rodrigues Daiana Cristina Silva , Albano Rodolpho Mattos , da Silva Fabrício Alves Barbosa , Marques Elizabeth Andrade , Leão Robson Souza , Carvalho-Assef Ana Paula D'Alincourt 

TITLE=Genetic Basis of Antimicrobial Resistant Gram-Negative Bacteria Isolated From Bloodstream in Brazil

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.635206

DOI=10.3389/fmed.2021.635206

ISSN=2296-858X

ABSTRACT=<p>Multidrug-resistant microorganisms are a well-known global problem, and gram-negative bacilli are top-ranking. When these pathogens are associated with bloodstream infections (BSI), outcomes become even worse. Here we applied whole-genome sequencing to access information about clonal distribution, resistance mechanism diversity and other molecular aspects of gram-negative bacilli (GNB) isolated from bloodstream infections in Brazil. It was possible to highlight international high-risk clones circulating in the Brazilian territory, such as CC258 for <italic>Klebsiella pneumoniae</italic>, ST79 for <italic>Acinetobacter baumannii</italic> and ST233 for <italic>Pseudomonas aeruginosa</italic>. Important associations can be made such as a negative correlation between CRISPR-Cas and <italic>K. pneumoniae</italic> CC258, while the genes <italic>bla</italic><sub>TEM</sub>, <italic>bla</italic><sub>KPC</sub> and <italic>bla</italic><sub>CTX−M</sub> are highly associated with this clone. Specific relationships between <italic>A. baumannii</italic> clones and <italic>bla</italic><sub>OXA−51</sub> variants were also observed. All <italic>P. aeruginosa</italic> ST233 isolates showed the genes <italic>bla</italic><sub>VIM</sub> and <italic>bla</italic><sub>OXA486</sub>. In addition, some trends could be identified, where a new <italic>P. aeruginosa</italic> MDR clone (ST3079), a novel <italic>A. baumannii</italic> clonal profile circulating in Brazil (ST848), and important resistance associations in the form of <italic>bla</italic><sub>VIM−2</sub> and <italic>bla</italic><sub>IMP−56</sub> being found together in one ST233 strain, stand out. Such findings may help to develop approaches to deal with BSI and even other nosocomial infections caused by these important GNB.</p>