NDM-5 and OXA-181 Beta-Lactamases, a Significant Threat Continues To Spread in the Americas

Rojas, Laura; Hujer, Andrea M.; Rudin, Susan D.; Wright, Meredith S.; Domitrovic, Tatiana; Marshall, Steven H.; Hujer, Kristine M.; Richter, Sandra; Cober, Eric; Pérez, Federico; Adams, Mark D.; Duin, David van; Bonomo, Robert A.

doi:10.1128/aac.00454-17

Cited by 71 publications

(58 citation statements)

References 33 publications

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“…Although NDM-5-producing strains are not as widespread as NDM-1-producing strains, they can also accompany multiple resistance gene determinants of resistance to different antimicrobials in the same strain, which makes them a potential public health threat. Furthermore, bla NDM-5 can occasionally occur simultaneously with bla OXA-181 (20)(21)(22), but bla OXA-181 was not found in our study. The NDM-5-producing strains described in our study showed high resistance to all ␤-lactams and inhibitors.…”

Section: Discussioncontrasting

confidence: 85%

“…Sixteen K. pneumoniae isolates carrying bla NDM-5 in our study belonged to the same sequence type, ST48, and had similar PFGE profiles, strongly indicating that clonal dissemination of K. pneumoniae carrying bla NDM-5 had occurred in our hospital. To our knowledge, bla NDM-5 -positive K. pneumoniae isolated from clinical samples has been identified in ST2250 in China (7), ST2266 in New Zealand (26), ST147 in the United States (21), and ST231 in Singapore (22) and in untypeable isolates in India (18). This is very possibly the first report in the world of ST48 carbapenem-resistant K. pneumoniae carrying the bla NDM-5 gene.…”

Section: Discussionmentioning

confidence: 66%

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Dissemination of the bla _NDM-5 Gene via IncX3-Type Plasmid among Enterobacteriaceae in Children

Tian

Wang

Zhang

et al. 2020

mSphere

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The continuous emergence of novel New Delhi metallo-␤-lactamase-5 (NDM-5)-producing Enterobacteriaceae isolates is receiving more and more public attention. Twenty-two NDM-5-producing strains were identified from 146 carbapenemase-producing Enterobacteriaceae (CRE) strains isolated from pediatric patients between January and March 2017, indicating that the bla NDM-5 gene has spread to children. All 22 isolates, including 16 Klebsiella pneumoniae strains, four Klebsiella aerogenes strains, and two Escherichia coli strains, showed significantly high resistance to ␤-lactam antibiotics (except aztreonam) but remained susceptible to tigecycline and colistin. K. pneumoniae and K. aerogenes strains were respectively defined as homologous clonal isolates by pulsed-field gel electrophoresis (PFGE). Multilocus sequence typing (MLST) results confirmed the genetic relatedness with all K. pneumoniae strains belonging to sequence type (ST) 48. Two E. coli isolates (ST617 and ST1236) were considered genetically unrelated. Twenty-two bla NDM-5 plasmids were positive for the IncX3 amplicon and showed almost identical profiles after digestion with HindIII and EcoRI. Four representative strains (K. pneumoniae K725, K. aerogenes CR33, E. coli Z214, and E. coli Z244) were selected for further study. Plasmids harboring bla NDM-5 showed strong stability in both clinical isolates and transconjugants, without apparent plasmid loss after 100 serial generations. S1-PFGE followed by Southern blot analysis demonstrated that the bla NDM-5 gene was located on an ϳ46-kb plasmid. Plasmid sequences of pNDM-K725, pNDM-CR33, and pNDM-Z214 were almost identical but were slightly different from that of pNDM-Z244. Compared with pNDM-Z244, ΔISAba125 and partial copies of IS3000 were missing. The genetic backgrounds of the bla NDM-5 gene in four strains were slightly different from that of the typical pNDM_MGR194. This study comprehensively characterized the horizontal gene transfer of the bla NDM-5 gene among different Enterobacteriaceae isolates in pediatric patients, and the IncX3-type plasmid was responsible for the spread. IMPORTANCE The emergence of CRE strains resistant to multiple antibiotics is considered a substantial threat to human health. Therefore, all the efforts to provide a detailed molecular transmission mechanism of specific drug resistance can contribute positively to prevent the further spread of multidrug-resistant bacteria. Although the new superbug harboring bla NDM-5 has been reported in many countries, it was mostly identified among E. coli strains, and the gene transfer mechanism has not been fully recognized and studied. In this work, we identified 22 bla NDM-5 -positive strains in different species of Enterobacteriaceae, including 16 Klebsiella pneumoniae strains, four Klebsiella aerogenes strains, and two Escherichia coli strains, which indicated the horizontal gene transfer of bla NDM-5 among Enterobacteriaceae strains in pediatric patients. Moreover, bla NDM-5 was located on a 46-kb IncX3 plasmid, which is possibly respon...

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Section: Discussioncontrasting

confidence: 85%

Section: Discussionmentioning

confidence: 66%

Dissemination of the bla _NDM-5 Gene via IncX3-Type Plasmid among Enterobacteriaceae in Children

Tian

Wang

Zhang

et al. 2020

mSphere

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“…To our knowledge, this is the first report describing clinical isolates of K. pneumoniae co-harboring genes encoding NDM-5 and OXA-232. Strains of K. pneumoniae co-producing NDM-5 and OXA-181 were isolated in Singapore in 2013 (Balm et al, 2013), South Korea in 2015 (Cho et al, 2015), the United Arab Emirates (Sonnevend et al, 2017), the United States (Rojas et al, 2017and Egypt in 2019(Soliman et al, 2019. In addition, a K. pneumoniae strain co-producing NDM-1 and OXA-181 was reported in 2013 in Singapore (Balm et al, 2013), and a strain co-producing NDM-7 and OXA-181 was reported in 2015 in Denmark (Hammerum et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Emergence of clinical isolates of highly carbapenem-resistant Klebsiella pneumoniae co-harboring blaNDM-5 and blaOXA-181 or -232 in Nepal

Sherchan

Tada

Shrestha

et al. 2020

International Journal of Infectious Diseases

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A B S T R A C TObjectives: The aim of this study was to describe the emergence in Nepal of clinical isolates of Klebsiella pneumoniae harboring both bla NDM-5 and bla OXA-181/-232 . Methods: Six clinical isolates of K. pneumoniae highly resistant to carbapenems and aminoglycosides were obtained from inpatients in Nepal. Their whole genomes were sequenced by a next generation sequencer.Results: The minimum inhibitory concentrations of meropenem, amikacin and ciprofloxacin were 128 m g/ml, >1024 mg/ml and 256 mg/ml, respectively. All six isolates co-harbored bla NDM-5 , bla OXA-181 or -232 and rmtB. Of them, 1 also harbored rmtF. The bla NDM-5 , bla OXA-232 and rmtB in all six isolates were located on plasmids. Of the six isolates tested, one isolate harbored two copies of bla OXA-181 and rmtF on the chromosome. Conclusions: This is the first report of clinical isolates of K. pneumoniae co-harboring bla NDM-5 , bla OXA-181 or -232 and rmtB in Nepal. These strains were highly carbapenem-and aminoglycoside-resistant, and belonged to ST147 or ST395. Of them, ST147 isolate harbored two copies of bla OXA-181 on the chromosome.

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“…In this study, the plasmid harboring the mcr gene in K. pneumoniae was similar to other IncHI2-type plasmids present in E. coli, and upstream of the mcr gene was the common ISApl1 transposon. NDM-5 has been reported in many other countries, including India [19], China [20], Denmark [21], Italy [22], America [23], and Spain [24]; it has also been isolated from pigs [25,26], dairy cows [27], and vegetables [28]. In the present study, the IncX3 plasmids harboring bla NDM−5 were highly similar in various sources, suggesting their ability to be an e cient vehicle for bla NDM−5 dissemination among humans, animals, food, and the environment via the human intestine.…”

Section: Discussionmentioning

confidence: 99%

Characterization of carbapenem non-susceptible Gram-negative Bacilli isolated from the feces of 10,000 inpatients in Southern China

Duan¹,

Li²,

Peng³

et al. 2020

Preprint

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Background Carbapenem non-susceptible Gram-negative bacilli (CNS-GNB) were dominant pathogen causing clinical infections. The human intestine was important reservoir of GNB, but there were few studies to analysis the prevalence of fecal colonization with them. Methods Fecal samples were collected from hosiptal screening test for GNB was conducted by using home-made MacConkey agar. Antimicrobial susceptibility was determined by the automatic microbiology analyzer and drug-resistant genes were characterized by polymerase chain reaction assays and DNA sequencing. The whole genome sequencing were used to analysis the characteristic of genetic structure of the isolates. Results A total of 680 CNS-GNB were collected. Acinetobacter spp. were the dominant species (33.8%) of the 22 genera. Carbapenemase genes were identified in 307 isolates (45.1%), including 206 (30.3%) blaNDM; 51 (7.5%) blaVIM−2, 48 (7.1%) blaIMP, and seven (1.0%) blaKPC−2. The blaNDM genes were first detected in three isolates, Providencia vermicola, Achromobacter spp., and Cupriavidus gilardii. Co-existence of blaVIM and blaIMP genes was detected in five isolates; Achromobacter co-producing VIM and IMP has not been previously reported. The mcr-1 gene was identified in five strains of Acinetobacter and one strain of K. pneumoniae. In addition, we detected seven isolates harboring the blaAFM−1 gene, a novel metallo-β-lactamase gene. This was first genomic analysis of ST11 K. pneumoniae co-producing NDM-5 and mcr-1, which revealed that blaNDM-5 and mcr-1 are located on two different plasmids. The plasmid harboring blaNDM-5, which was composed of a typical IncX3-type backbone, and the mcr-1 gene, was located between an IS30-like element ISApl1 and a PAP2-like encoding gene in the IncHI2-type plasmid. Conclusions the overall prevalence of fecal carriage of CNS-GNB in 10,000 stool samples was 7.45%, and more than half of CNS-GNB produced carbapenemase. Most CNS-GNB cases were associated with infectious disease, multiple hospitalizations, or long-term care, and a high prevalence of underlying disease.

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NDM-5 and OXA-181 Beta-Lactamases, a Significant Threat Continues To Spread in the Americas

Cited by 71 publications

References 33 publications

Dissemination of the bla _NDM-5 Gene via IncX3-Type Plasmid among Enterobacteriaceae in Children

Dissemination of the bla _NDM-5 Gene via IncX3-Type Plasmid among Enterobacteriaceae in Children

Emergence of clinical isolates of highly carbapenem-resistant Klebsiella pneumoniae co-harboring blaNDM-5 and blaOXA-181 or -232 in Nepal

Characterization of carbapenem non-susceptible Gram-negative Bacilli isolated from the feces of 10,000 inpatients in Southern China

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NDM-5 and OXA-181 Beta-Lactamases, a Significant Threat Continues To Spread in the Americas

Cited by 71 publications

References 33 publications

Dissemination of the bla NDM-5 Gene via IncX3-Type Plasmid among Enterobacteriaceae in Children

Dissemination of the bla NDM-5 Gene via IncX3-Type Plasmid among Enterobacteriaceae in Children

Emergence of clinical isolates of highly carbapenem-resistant Klebsiella pneumoniae co-harboring blaNDM-5 and blaOXA-181 or -232 in Nepal

Characterization of carbapenem non-susceptible Gram-negative Bacilli isolated from the feces of 10,000 inpatients in Southern China

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Dissemination of the bla _NDM-5 Gene via IncX3-Type Plasmid among Enterobacteriaceae in Children

Dissemination of the bla _NDM-5 Gene via IncX3-Type Plasmid among Enterobacteriaceae in Children