Characterization of NDM-5-Producing Escherichia coli Strains Isolated from Pediatric Patients with Bloodstream Infections in a Chinese Hospital

Abstract

Escherichia coli (E. coli) bloodstream infections (BSIs) are among the most predominant causes of death in infants and children worldwide. NDM-5 (New Delhi Metallo-lactamase-5) is responsible for one of the main mechanisms of carbapenem resistance in E. coli. To analyze the phenotypic and genomic characteristics of NDM-5-producing E. coli from bloodstream infections (BSIs), a total of 114 E. coli strains was collected from a children’s hospital in Jiangsu province, China. Eight blaNDM-5-carrying E. coli strains were identified which were all carbapenem-resistant and carried diverse antimicrobial resistance genes apart from blaNDM-5. They belonged to six distinct sequence types (STs) and serotypes including one each for ST38/O7:H8, ST58/O?:H37, ST131/O25:H4, ST156/O11:H25 and ST361/O9:H30 and three strains are originating from a single clone belonging to ST410/O?:H9. Apart from blaNDM-5, the E. coli strains isolated from BSIs also carried other β-lactamase genes, including blaCMY-2 (n = 4), blaCTX-M-14 (n = 2), blaCTX-M-15 (n = 3), blaCTX-M-65 (n = 1), blaOXA-1 (n = 4) and blaTEM-1B (n = 5). The blaNDM-5 genes were located on three different types of plasmids, which were IncFII/I1 (n = 1), IncX3 (n = 4) and IncFIA/FIB/FII/Q1 (n = 3). The former two types were conjugatively transferable at frequencies of 10−3 and 10−6, respectively. The dissemination of NDM-producing strains, which exhibit resistance to the last-line antibiotics, carbapenems, may increase the muti-antimicrobial resistance burden among E. coli BSIs and further threaten public health.

First Emergence of NDM-5 and OqxAB Efflux Pumps Among Multidrug-Resistant Klebsiella pneumoniae Isolated from Pediatric Patients in Assiut, Egypt

“…It has been reported that bla NDM-5 closely associated with different types of plasmids; among these, the IncF plasmid was found mainly in Enterobacteriaceae and has the ability to transfer its antimicrobial resistance determinants. 49 On the other hand, genotyping similarity between strains was found between these isolates (St-37, St-29, St-40) and between two isolates (St-42, St26). This indicated the capability of these NDM-5-producing strains to disseminate between different wards of this pediatric hospital.…”

Low prevalence of mobilized resistance genes blaNDM, mcr-1, and tet(X4) in Escherichia coli from a hospital in China

“…ST156 has been frequently described as bla NDM−5 carriers in patients and animals in China (Yang et al, 2016;Tang et al, 2019;Lin et al, 2020;Zhang et al, 2022). ST361 has been previously associated with bla NDM−5 in patients worldwide (Park et al, 2020;Chakraborty et al, 2021;Huang et al, 2023). ST1193 has been the dominant ST of carbapenem-sensitive E. coli isolates in patients at an intensive care unit in China (Ding et al, 2023).…”