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10.3390/microorganisms12091753
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Article

Emergence of NDM-1-Producing Pseudomonas aeruginosa Nosocomial Isolates in Attica Region of Greece

by
Olga Pappa
1,
Christina Louka
2,
Kleon Karadimas
1,
Evangelia Maikousi
1,
Angeliki Tzoukmani
1,
Michalis Polemis
1,
Anna-Danai Panopoulou
3,
Ioannis Daniil
2,
Stella Chryssou
3,
Kassiani Mellou
4,
Jette S. Kjeldgaard
5,
Olympia Zarkotou
2,
Costas Papagiannitsis
6 and
Kyriaki Tryfinopoulou
1,7,*
1
AMR and HAIs Laboratory, Central Public Health Laboratory, National Public Health Organization, Vari, 16672 Attica, Greece
2
Clinical Microbiology Laboratory, Tzaneion General Hospital of Piraeus, 18536 Attica, Greece
3
Clinical Microbiology Laboratory, Syggros Hospital of Athens, 16121 Attica, Greece
4
Directorate of Epidemiological Surveillance and Response for Infectious Diseases, National Public Health Organization, 15123 Athens, Greece
5
European Union Reference Laboratory for Antimicrobial Resistance (EURL-AR), National Food Institute, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
6
Department of Microbiology, University Hospital of Larissa, 41334 Larissa, Greece
7
Clinical Microbiology and Microbial Pathogenesis Laboratory, School of Medicine, University of Crete, Heraklion, 71500 Crete, Greece
*
Author to whom correspondence should be addressed.
Microorganisms 2024, 12(9), 1753; https://doi.org/10.3390/microorganisms12091753
Submission received: 2 August 2024 / Revised: 19 August 2024 / Accepted: 21 August 2024 / Published: 23 August 2024
(This article belongs to the Special Issue New Perspectives in Controlling the Spread of Multi-Drug Resistance Organisms (MDROs))
Review Reports Versions Notes

Abstract

Here, we report on the emergence and spread of multidrug-resistant NDM-1-producing P. aeruginosa isolates from patients hospitalized in the Attica region, Greece, in 2022 to provide data on their resistome, their virulome, the genetic environment of blaNDM-1, and their molecular epidemiology. A total of 17 carbapenem-resistant P. aeruginosa isolates identified as NDM-producers by immunochromatography at the hospital level were sent to the Central Public Health Laboratory, in the frame of the laboratory surveillance of carbapenem-resistant pathogens, for further characterization. The initial screening for genetic AMR determinants was carried out by PCR and the MDR Direct Flow Chip assay. Typing was performed by MLST and DLST, the latter in a subset of isolates. Further analysis was performed by whole-genome sequencing (WGS) of six isolates from both hospitals to analyze their entire genomes and elucidate their genetic relatedness. All isolates were allocated to international high-risk clones, sixteen to ST773 and one to ST308. Five ST773 and the sole ST308 isolate were found to harbor the blaNDM-1 gene, along with various other ARGs integrated into their chromosomes, as well as with a wide variety of virulence genes. The blaNDM-1 gene was located in the integrative and conjugative elements ICE6600-like and ICETn43716385 in ST773 and ST308 isolates, respectively. Single-nucleotide polymorphism analysis of the five ST773 isolates indicated their clonal spread in both hospitals. These results suggested that two different molecular events contributed to the emergence of NDM-1-producing P. aeruginosa isolates in Athenian hospitals, highlighting the need for ongoing surveillance.
Keywords: P. aeruginosa; multidrug resistance; high-risk clones; NDM-1; Greece P. aeruginosa; multidrug resistance; high-risk clones; NDM-1; Greece

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MDPI and ACS Style

Pappa, O.; Louka, C.; Karadimas, K.; Maikousi, E.; Tzoukmani, A.; Polemis, M.; Panopoulou, A.-D.; Daniil, I.; Chryssou, S.; Mellou, K.; et al. Emergence of NDM-1-Producing Pseudomonas aeruginosa Nosocomial Isolates in Attica Region of Greece. Microorganisms 2024, 12, 1753. https://doi.org/10.3390/microorganisms12091753

AMA Style

Pappa O, Louka C, Karadimas K, Maikousi E, Tzoukmani A, Polemis M, Panopoulou A-D, Daniil I, Chryssou S, Mellou K, et al. Emergence of NDM-1-Producing Pseudomonas aeruginosa Nosocomial Isolates in Attica Region of Greece. Microorganisms. 2024; 12(9):1753. https://doi.org/10.3390/microorganisms12091753

Chicago/Turabian Style

Pappa, Olga, Christina Louka, Kleon Karadimas, Evangelia Maikousi, Angeliki Tzoukmani, Michalis Polemis, Anna-Danai Panopoulou, Ioannis Daniil, Stella Chryssou, Kassiani Mellou, and et al. 2024. "Emergence of NDM-1-Producing Pseudomonas aeruginosa Nosocomial Isolates in Attica Region of Greece" Microorganisms 12, no. 9: 1753. https://doi.org/10.3390/microorganisms12091753

APA Style

Pappa, O., Louka, C., Karadimas, K., Maikousi, E., Tzoukmani, A., Polemis, M., Panopoulou, A.-D., Daniil, I., Chryssou, S., Mellou, K., Kjeldgaard, J. S., Zarkotou, O., Papagiannitsis, C., & Tryfinopoulou, K. (2024). Emergence of NDM-1-Producing Pseudomonas aeruginosa Nosocomial Isolates in Attica Region of Greece. Microorganisms, 12(9), 1753. https://doi.org/10.3390/microorganisms12091753

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