Multidrug-resistant enterobacterales carrying the acc(6')-Ian gene
Kristel G Soto-Flores1, Jimena R Cisneros-Aguilar1, Maricecy K Rueda-Vicente1
1Universidad de Piura, Lima, Peru.
Revista Peruana De Medicina Experimental Y Salud Publica
|July 30, 2026
Summary
Carbapenem-resistant Enterobacterales strains from Peru carry multiple resistance genes on plasmids. These genes spread easily between bacteria, increasing the risk of difficult-to-treat infections and highlighting the need for surveillance.
Area of Science:
- Microbiology
- Genetics
- Infectious Diseases
Background:
- Carbapenemase-producing Enterobacterales (CPE) are a growing global health threat.
- Urinary tract infections caused by CPE are associated with significant morbidity and mortality.
- Limited data exists on CPE epidemiology in Peru.
Purpose of the Study:
- To characterize carbapenem-resistant Enterobacterales isolates from urine samples in Lima, Peru.
- To identify resistance genes and mobile genetic elements associated with CPE.
- To investigate the role of plasmids in the dissemination of antimicrobial resistance.
Main Methods:
- Phenotypic and genotypic characterization of 84 carbapenem-resistant Klebsiella pneumoniae and Escherichia coli isolates.
- Detection of antimicrobial resistance genes, including aac(6')-Ian, blaNDM, blaPER-2, and qnrVC1.
- Plasmid analysis, conjugation assays, and whole-genome sequencing.
Main Results:
- 13 out of 84 isolates carried the aac(6')-Ian gene, conferring resistance to amikacin and other aminoglycosides.
- All isolates harbored blaNDM, blaPER-2, and qnrVC1 genes on IncC2-type plasmids.
- Conjugation assays confirmed efficient plasmid transfer, demonstrating high horizontal gene transfer potential.
- Genomic analyses revealed co-occurrence of resistance genes and mobile genetic elements on plasmids.
Conclusions:
- Plasmids play a crucial role in the dissemination of multidrug resistance genes among Enterobacterales in clinical settings in Peru.
- The genetic environment identified facilitates rapid spread of carbapenem resistance.
- Enhanced surveillance measures are essential to mitigate the risk of CPE infections in healthcare settings.
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