Carbapenemase-producing rare Enterobacterales in hospital food: a Latin American one health blind spot.

INTRODUCTION

Carbapenemase-producing Enterobacterales (CPE) are a global public health concern. These bacteria are very common in human infections, but reports of their presence in the food chain are increasing and could represent alternative routes for colonization and infection. Hence, we conducted a surveillance study to investigate CPE in food distributed to patients at a tertiary hospital in Brazil.

METHODS

The samples were collected right before distribution and screened for β-lactam-resistant Enterobacterales. Isolates that exhibited carbapenem resistance were screened for NDM, IMP, VIM, OXA-48-like, and KPC carbapenemase genes by multiplex polymerase chain reaction (PCR), and those identified as CPE underwent whole-genome sequencing.

RESULTS

Accordingly, we report the detection of a KPC-2-producing Superficieibacter electus, a KPC- 2-producing Pseudocitrobacter faecalis, and two NDM-1-producing Leclercia adecarboxylata isolated from four distinct food samples. The carbapenemase genes were harbored by plasmids, and the genomic traits indicate their potential to cause hard-to-treat human infections or serve as a reservoir of important antimicrobial resistance genes. Moreover, despite the 3-month time span between collections, the two L. adecarboxylata isolates exhibited high similarity, suggesting horizontal transmission of CPE associated with the hospital food service.

DISCUSSION: Thus, the emergence of rare Enterobacterales raises concerns about the potential for silently spreading, hard-to-treat infections.