Genomic surveillance of Pseudomonas aeruginosa in the Philippines, 2013-2014
Abstract
Pseudomonas aeruginosa is an opportunistic pathogen that often causes nosocomial infections resistant to treatment. Rates of antimicrobial resistance (AMR) are increasing, as are rates of multidrug-resistant (MDR) and possible extensively drug-resistant (XDR) infections. Our objective was to characterize the molecular epidemiology and AMR mechanisms of this pathogen. We sequenced the whole genome for each of 176 P. aeruginosa isolates collected in the Philippines in 2013-2014; derived the multilocus sequence type (MLST), presence of AMR determinants and relatedness between isolates; and determined concordance between phenotypic and genotypic resistance. Carbapenem resistance was associated with loss of function of the OprD porin and acquisition of the metallo-β-lactamase (MBL) gene bla VIM. Concordance between phenotypic and genotypic resistance was 93.27% overall for six antibiotics in three classes, but varied among aminoglycosides. The population of P. aeruginosa was diverse, with clonal expansions of XDR genomes belonging to MLSTs ST235, ST244, ST309 and ST773. We found evidence of persistence or reintroduction of the predominant clone ST235 in one hospital, and of transfer between hospitals. Most of the ST235 genomes formed a distinct lineage from global genomes, thus raising the possibility that they may be unique to the Philippines. In addition, long-read sequencing of one representative XDR ST235 isolate identified an integron carrying multiple resistance genes (including bla VIM-2), with differences in gene composition and synteny from the P. aeruginosa class 1 integrons described previously. The survey bridges the gap in genomic data from the Western Pacific Region and will be useful for ongoing surveillance; it also highlights the importance of curtailing the spread of ST235 within the Philippines.
Citation
Philippines Antimicrobial Resistance Surveillance Program , Chilam , J , Argimón , S , Limas , M T , Masim , M L , Gayeta , J M , Lagrada , M L , Olorosa , A M , Cohen , V , Hernandez , L T , Jeffrey , B , Abudahab , K , Hufano , C M , Sia , S B , Holden , M T G , Stelling , J , Aanensen , D M & Carlos , C C 2021 , ' Genomic surveillance of Pseudomonas aeruginosa in the Philippines, 2013-2014 ' , Western Pacific Surveillance and Response Journal , vol. 12 , no. 2 , pp. 4-18 . https://doi.org/10.5365/wpsar.2020.11.1.006
Publication
Western Pacific Surveillance and Response Journal
Status
Peer reviewed
ISSN
2094-7321Type
Journal article
Rights
Copyright © World Health Organization (WHO) 2018. Some rights reserved. The articles in this publication are published by the World Health Organization and contain contributions by individual authors. The articles are available under the Creative Commons Attribution 3.0 IGO license (CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/legalcode), which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. In any use of these articles, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted.
Description
This work was supported by a Newton Fund award from the Medical Research Council (United Kingdom) MR/N019296/1 and the Philippine Council for Health Research and Development. Additional support was provided by the National Institute for Health Research (United Kingdom) Global Health Research Unit on Genomic Surveillance of AMR (16/136/111) and by a research grant U01CA207167 from the National Institutes of Health (USA).Collections
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