Tipificación de aislamientos de Ralstonia mannitolilytica en un hospital pediátrico de la Ciudad de México

Alejandra Aquino-Andrade; Jocelin Merida-Vieyra; Antonino Lara-Hernández; Hilda Hernández-Orozco; Agustin De Colsa-Ranero

doi:10.18233/APM43No2pp73-782392

Alejandra Aquino-Andrade INSTITUTO NACIONAL DE PEDIATRÍA
Jocelin Merida-Vieyra INSTITUTO NACIONAL DE PEDIATRÍA
Antonino Lara-Hernández INSTITUTO NACIONAL DE PEDIATRÍA
Hilda Hernández-Orozco INSTITUTO NACIONAL DE PEDIATRÍA
Agustin De Colsa-Ranero INSTITUTO NACIONAL DE PEDIATRÍA

DOI: https://doi.org/10.18233/APM43No2pp73-782392

Resumen

Introducción: Ralstonia mannitolilytica es un agente causal de infecciones asociadas al cuidado de la salud. Las especies del género Ralstonia son difíciles de identificar y diferenciar. Nuestro objetivo fue identificar y tipificar aislamientos de R. mannitolilytica obtenidos de hemocultivos de pacientes pediátricos. Métodos: Colectamos 10 aislamientos de R. mannitolilytica identificados con un sistema automatizado, un sistema de espectrometría de masas con analizador de tiempo de vuelo y desorción mediante láser asistida por matriz (MALDI-TOF-MS, Matrix-assisted laser desorption/ionization time of flight mass spectrometry) y análisis del gen 16S rRNA. Se determinó el perfil de resistencia y se tipificaron las carbapenemasas a través de PCR y secuenciación. Se estableció la relación clonal de los aislamientos mediante electroforesis en gel de campos pulsados (PFGE). Resultados: El sistema MALDI-TOF-MS y análisis del gen 16S rRNA identificaron a los aislamientos como R. mannitolilytica; todos pertenecieron a la misma clona y fueron resistentes a meropenem, se detectaron a las carbapenemasas OXA-443 y OXA-444 en todos ellos. Conclusiones: Este es el primer reporte de aislamientos de R. mannitolilytica con origen clonal y que poseen las carbapenemasas OXA-443 y OXA-444 en pacientes pediátricos mexicanos.

Citas

Daxboeck F, Stadler M, Assadian O, Marko E, Hirschl AM, Koller W. Characterization of clinically isolated Ralstonia mannitolilytica strains using random amplification of polymorphic DNA (RAPD) typing and antimicrobial sensitivity, and comparison of the classification efficacy of phenotypic and genotypic assays. J Med Microbiol. 2005;54:55–61.

Ryan MP, Adley CC. Ralstonia spp.: emerging global opportunistic pathogens. Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol. 2014;33:291–304.

Block C, Ergaz-Shaltiel Z, Valinsky L, Temper V, Hidalgo-Grass C, Minster N, et al. Déjà vu: Ralstonia mannitolilytica infection associated with a humidifying respiratory therapy device, Israel, June to July 2011. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2013;18:20471.

De Baere T, Steyaert S, Wauters G, Des Vos P, Goris J, Coenye T, et al. Classification of Ralstonia pickettii biovar 3/’thomasii’ strains (Pickett 1994) and of new isolates related to nosocomial recurrent meningitis as Ralstonia mannitolytica sp. nov. Int J Syst Evol Microbiol. 2001;51:547–558.

Vaneechoutte M, De Baere T, Wauters G, Steyaert S, Claeys G, Vogelaers D, et al. One case each of recurrent meningitis and hemoperitoneum infection with Ralstonia mannitolilytica. J Clin Microbiol. 2001;39:4588–4590.

Coenye T, Vandamme P, LiPuma JJ. Infection by Ralstonia species in cystic fibrosis patients: identification of R. pickettii and R. mannitolilytica by polymerase chain reaction. Emerg Infect Dis. 2002;8:692–696.

Mukhopadhyay C, Bhargava A, Ayyagari A. Ralstonia mannitolilytica infection in renal transplant recipient: first report. Indian J Med Microbiol. 2003;21:284–286.

Zong ZY, Peng CH. Ralstonia mannitolilytica and COPD: a case report. Eur Respir J. 2011;38:1482–1483.

Liu C-X, Yan C, Zhang P, Li F-Q, Yang J-H, Li X-Y. Ralstonia mannitolilytica-induced septicemia and homology analysis in infected patients: 3 Case Reports. Jundishapur J Microbiol. 2016;9:e34373.

Sharma D, Sharma P, Soni P, Gupta B. Ralstonia picketti neonatal sepsis: a case report. BMC Res Notes. 2017;10:28.

Maroye P, Doermann HP, Rogues AM, Gachie JP, Mégraud F. Investigation of an outbreak of Ralstonia pickettii in a paediatric hospital by RAPD. J Hosp Infect. 2000;44:267–272.

Pellegrino FLPC, Schirmer M, Velasco E, de Faria LM, Santos KRN, Moreira BM. Ralstonia pickettii bloodstream infections at a Brazilian cancer institution. Curr Microbiol. 2008;56:219–223.

Clinical Laboratory Standards Institute . Performance Standards for Antimicrobial Susceptibility Testing; 25th informational supplement MI00-S25. Vol. 35. Wayne, Pennsylvania, PA: CLSI; 2015.

Dallenne C, Da Costa A, Decré D, Favier C, Arlet G. Development of a set of multiplex PCR assays for the detection of genes encoding important beta-lactamases in Enterobacteriaceae. J Antimicrob Chemother. 2010;65:490–495.

Nordmann P, Poirel L, Carrër A, Toleman MA, Walsh TR. How to detect NDM-1 producers. J Clin Microbiol. 2011;49:718–721.

Brink AJ, Coetzee J, Corcoran C, Clay CG, Hari-Makkan D, Jacobson RK, et al. Emergence of OXA-48 and OXA-181 carbapenemases among Enterobacteriaceae in South Africa and evidence of in vivo selection of colistin resistance as a consequence of selective decontamination of the gastrointestinal tract. J Clin Microbiol. 2013;51:369–372.

Ye J, Coulouris G, Zaretskaya I, Cutcutache I, Rozen S, Madden TL. Primer-BLAST: a tool to design target-specific primers for polymerase chain reaction. BMC Bioinformatics. 2012;13:134.

Suzuki M, Nishio H, Asagoe K, Kida K, Suzuki S, Matsui M, et al. Genome sequence of a carbapenem-resistant strain of Ralstonia mannitolilytica. Genome Announc. 2015;3: e00405-15.

Morgulis A, Coulouris G, Raytselis Y, Madden TL, Agarwala R, Schäffer AA. Database indexing for production MegaBLAST searches. Bioinforma Oxf Engl. 2008;24:1757–1764.

Zhang Z, Schwartz S, Wagner L, Miller W. A greedy algorithm for aligning DNA sequences. J Comput Biol. 2000; 7: 203-14.

Relman DA. Universal bacterial 16S rDNA amplification and sequencing. En: Persing DH, Smith TF, Tenover FC, White TT (ed), Diagnostic Molecular Microbiology: Principles and Applications. Washington, D.C: American Society of Microbiology, 1993, pp 489-95.

Khattak MN, Matthews RC, Burnie JP. Is Bordetella pertussis clonal? BMJ. 1992;304:813–815.

Tenover FC, Arbeit RD, Goering RV, Mickelsen PA, Murray BE, Persing DH, Swaminathan B. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol. 1995;33:2233–2239.

Fernández-Olmos A, García-Castillo M, Morosini M-I, Lamas A, Máiz L, Cantón R. MALDI-TOF MS improves routine identification of non-fermenting Gram negative isolates from cystic fibrosis patients. J Cyst Fibros Off J Eur Cyst Fibros Soc. 2012;11:59–62.

Marko DC, Saffert RT, Cunningham SA, Hyman J, Walsh J, Arbefeville S, et al. Evaluation of the Bruker Biotyper and Vitek MS matrix-assisted laser desorption ionization-time of flight mass spectrometry systems for identification of nonfermenting gram-negative bacilli isolated from cultures from cystic fibrosis patients. J Clin Microbiol. 2012;50:2034–2039.

Prior P, Ailloud F, Dalsing BL, Remenant B, Sanchez B, Allen C. Genomic and proteomic evidence supporting the division of the plant pathogen Ralstonia solanacearum into three species. BMC Genomics. 2016;17:90-100.

Gröbner S, Heeg P, Autenrieth IB, Schulte B. Monoclonal outbreak of catheter-related bacteraemia by Ralstonia mannitolilytica on two haemato-oncology wards. J Infect. 2007;55:539–544.

Dotis J, Printza N, Orfanou A, Papathanasiou E, Papachristou F. Peritonitis due to Ralstonia mannitolilytica in a pediatric peritoneal dialysis patient. New Microbiol. 2012;35:503–506.

Labarca JA, Trick WE, Peterson CL, Carson LA, Holt SC, Arduino MJ, et al. A multistate nosocomial outbreak of Ralstonia pickettii colonization associated with an intrinsically contaminated respiratory care solution. Clin Infect Dis Off Publ Infect Dis Soc Am. 1999;29:1281–1286.