Abstract
Abstract Background Public Health Laboratories (PHL) across 50 U.S. states, several cities and Puerto Rico participate in CDC’s Antimicrobial Resistance Laboratory Network (AR Lab Network), to test clinical isolates of carbapenem-resistant Pseudomonas aeruginosa (CRPA) and Acinetobacter baumannii (CRAB) for the presence of targeted carbapenemase (CP) genes. PHLs have submitted reports of these targeted genes in CR non-aeruginosa Pseudomonas (CR-NAP) and non-baumannii Acinetobacter (CR-NBA) isolates. Here we describe the ad-hoc detection of targeted CP genes in CR-NAP and CR-NBA species tested by the Network. Methods Clinical laboratories submitted CR isolates to PHLs for organism identification. Isolates were deemed suspected CR-NAP and CR-NAB when a PHL ruled out aeruginosa or baumannii, respectively, but their MALDI ToF MS database prevented further speciation. PHLs used real-time polymerase chain reaction or whole genome sequencing to detect the presence of targeted CP genes: blaKPC,blaNDM,blaOXA-48-like,blaIMP, and blaVIM in Pseudomonas and Acinetobacter, and blaOXA-23-like,blaOXA-24/40-like, and blaOXA-58-like in Acinetobacter. Results During 2017–2021, the AR Lab Network tested 56,092 CR-Pseudomonas isolates, 71 of which were CR-NAP; P. putida (n=15; 21%), P. fluorescens (12; 17%) P. otitidis (5; 7%), P. monteilii (3; 4%), 1 (1%) each of P. koreensis and P. mosselii, and 34 (48%) other suspected CR-NAP. Three (4%) of the 71 CR-NAP isolates tested carried a targeted CP gene: 1 P. fluorescens with blaIMP, 1 P. putida with blaVIM, and 1 P. Japonica with blaKPC. Of 13,624 CR-Acinetobacter isolates tested, 25 (< 1%) were CR-NBA; A. pitti (10; 40%), A. radioresistens (6; 24%), A. variabilis (2; 8%), 1 (4%) each of A. berezinaiae, A. lwoffii, and A. ursingii, and 4 (16%) other suspected CR-NBA. The A. variabilis isolates each harbored both blaNDM and blaOXA-58-like genes. Conclusion Although CR-NAP and CR-NBA isolates are not solicited by the Network, some of these species are submitted for characterization. Our findings suggest these other species do harbor some targeted CP genes and may represent unmonitored reservoirs for CP gene spread in the U.S. An expansion of testing to include these species in the AR Lab Network may improve our ability to slow the spread of antimicrobial resistance. Disclosures All Authors: No reported disclosures
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