Genomic Characterisation of ST233 Pseudomonas aeruginosa Co-producing KPC-2 and VIM-2 in Northeastern Brazil During the COVID-19 Pandemic: Evidence of Independent Horizontal Acquisition Events.

Authors

Joanderson Cadena da Silva, Ivson Cassiano de Oliveira Santos, Orlando Carlos da Conceição-Neto, Melise Chaves Silveira, Bruna Ribeiro Sued-Karam, Daiana Cristina Silva Rodrigues, Gabriela Alves da Silva, Stefany Mendes Dimas, Irys Hany Lima Gonzalez, Bruno Rocha Pribul, Ana Paula D'Alincourt Carvalho-Assef, Cláudio Marcos Rocha-de-Souza

Published in

Journal of global antimicrobial resistance. Aug 20, 2026. Epub Aug 20, 2026.

Abstract

Dual-carbapenemase-producing Pseudomonas aeruginosa poses a major therapeutic and epidemiological challenge worldwide, yet systematic data on KPC and VIM co-production in Brazil remain limited. The COVID-19 pandemic intensified antimicrobial use, a period temporally associated with increased carbapenemase detection globally.
To characterise the molecular epidemiology and resistance profiles of KPC and VIM co-producing P. aeruginosa isolates from Brazil (2019-2023).
Between 2019 and 2023, 1,489 multidrug-resistant P. aeruginosa isolates were screened by multiplex PCR for carbapenemase-encoding genes. Co-producing isolates underwent pulsed-field gel electrophoresis (PFGE) for clonal profiling, followed by whole-genome sequencing (WGS) for high-resolution phylogenomic analysis. Antimicrobial susceptibility testing and plasmid characterisation using next-generation sequencing platforms were also performed.
Forty-two isolates (2.8%) harboured both bla_KPC-2 and bla_VIM-2, with detection occurring exclusively between 2020 and 2023, temporally coinciding with the COVID-19 pandemic. PFGE identified eight distinct clonal groups, providing evidence for independent horizontal gene transfer (HGT) events, whilst WGS confirmed all isolates as the high-risk ST233 lineage. Chromosomally integrated bla_VIM-2 within class 1 integrons predominated; two isolates carried dual chromosomal copies. Plasmid-borne bla_KPC-2 was identified across heterogeneous replicons (43.3-430.1 kb), suggesting multiple independent acquisition events. All co-producing isolates displayed extensive drug resistance, retaining in vitro susceptibility only to cefiderocol and colistin.
ST233 co-producing KPC and VIM, represents a high-risk resistance phenotype of epidemiological significance. Divergent genomic architectures suggest active horizontal dissemination across diverse genetic backgrounds rather than clonal expansion, highlighting the need for enhanced surveillance and infection control strategies.

PMID:
42624328
Bibliographic data and abstract were imported from PubMed on 21 Aug 2026.

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