First nationwide survey on Pseudomonas aeruginosa in Bolivia: susceptibility profiles, resistome, and genomic epidemiology

ABSTRACT Information on the molecular epidemiology of Pseudomonas aeruginosa and antimicrobial resistance mechanisms is still limited in some South American countries. This study aims to decipher the population structure of 111 extensive drug-resistant P. aeruginosa isolates from a national study co...

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Authors: Alvarado-Orosco, Neisa, Gomis Font, Maria Antònia, Sastre-Femenia, Miquel Àngel, Ribera Ortiz, Silvia, Miranda Arce, Maritza, Araúz Barba, María Elena, Navia Durán, María del Rosario, Vargas Nattez, Sandra Grisel, Cabellos Astorga, Gabriela, Villarroel Rodriguez, Paola Janeth, Almaraz Roca, Damariz Daniela, Castillo Cruz, Marleni, Chambi Condori, Juan Pablo, Quevedo Ribera, Pedro, Patino García, Suan Mishelly, Contreras Otalora, Yenny, Rosales Rea, Flor María, Portugal Gutiérrez, Claudia Milena, Sánchez Serrano, Marisol, López-Causapé, Carla, Oliver, Antonio
Format: article
Publication Date:2025
Country:España
Institution:Conselleria de Salut i Consum del Govern de les Illes Balears
Repository:Docusalut
Language:English
OAI Identifier:oai:docusalut.com:20.500.13003/26261
Online Access:https://hdl.handle.net/20.500.13003/26261
Access Level:Open access
Keyword:Pseudomonas aeruginosa
Drug Resistance, Microbial
beta-Lactam Resistance
Genomic Medicine
Farmacorresistencia Microbiana
Resistencia betalactámica
Medicina Genómica
antimicrobial resistance
genomic epidemiology
Description
Summary:ABSTRACT Information on the molecular epidemiology of Pseudomonas aeruginosa and antimicrobial resistance mechanisms is still limited in some South American countries. This study aims to decipher the population structure of 111 extensive drug-resistant P. aeruginosa isolates from a national study conducted in Bolivia during 2023–2024. The antibiotic susceptibility profiles were determined for 15 antipseudomonal agents. All isolates were subjected to whole-genome sequencing (WGS), and, through bioinformatics analysis, sequence types (ST), clonal relatedness, and acquired mutation-driven and transferable resistance mechanisms were elucidated. The most active antipseudomonal agents were colistin (98.2% intermediate, MIC 50/90 =1/2 mg/L) and cefiderocol (92.7% susceptible, MIC 50/90 =0.25/4 mg/L) according to the Clinical and Laboratory Standards Institute (CLSI). High resistance rates to ceftazidime/avibactam (79.3%), ceftolozane/tazobactam (82.9%), and imipenem/relebactam (71.2%) were documented. Carbapenemases were found in 60.3%, particularly including metallo-β-lactamases (MBL), such as SPM-1 (35%), VIM-2 (9%), the co-production of NDM-1 and DIM-1 (4%), or the new IMP variant IMP-111. Extended-spectrum β-lactamases (ESBLs) were detected in 12% of the isolates, including OXA-17 (7%), PER-1 (3%), and some GES variants. The most commonly detected clone was ST277 (35%) associated with SPM-1, followed by the ST309 (25%) producer of OXA-2 and various GES, and ST235 (20%) related with OXA-17 and new IMP-111. These clones harbored other acquired resistance genes, including emerging 16S rRNA methyltransferases, RmtD and RmtG. The high resistance rates for novel beta-lactams linked to an alarming spread of high-risk clones ST277 and ST235 and the very high prevalence of MBLs and ESBLs raise significant concern. This underscores the urgent need for establishing epidemiological surveillance and infection control strategies.

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