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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
PubMed

Insights

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.
Keywords:
AmikacinDrug Resistance, MicrobialEnterobacteriaceaePeru

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