A public health concern: emergence of carbapenem-resistant Klebsiella pneumoniae in a public transportation environment

Abstract

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Objectives</jats:title> <jats:p>This study was designed to understand the prevalence of antibiotic-resistant bacteria in the Beijing subway environment and the potential transmission of carbapenem-resistant Enterobacteriaceae in a public transportation environment.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Carbapenem-resistant isolates were selected on brain heart infusion agar supplemented with meropenem (0.5 mg/L) and antimicrobial susceptibility testing was conducted using the broth microdilution method. WGS analyses were conducted for 11 Klebsiella pneumoniae isolates to identify resistance genes. The genetic relationships among the isolates were evaluated by MLST and PFGE.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>We identified 11 carbapenem-resistant K. pneumoniae isolates from the Beijing subway environment. WGS revealed three STs among the 11 isolates, with 9 isolates classified as ST726 and containing a blaNDM-5-carrying IncX3 plasmid. The genetic environment of blaNDM-5 was very similar to that observed in other blaNDM-5-containing clinical isolates.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The presence of carbapenem-resistant Enterobacteriaceae in a public transportation environment is concerning and indicates that regular antimicrobial resistance surveillance is urgent and necessary.</jats:p> </jats:sec>

Acquisition of a Stable and Transferable blaNDM-5-Positive Plasmid With Low Fitness Cost Leading to Ceftazidime/Avibactam Resistance in KPC-2-Producing Klebsiella pneumoniae During Treatment

“…Our results indicated that bla NDM-5 was contained on IncX3-type plasmid in KP137060. IncX3 plasmids were usually detected in clinical bla NDM-5 -positive bacteria in China ( Cao et al., 2020 ; Gao et al., 2020 ). The results of BLAST demonstrated that the bla NDM-5 -harboring plasmid showed >99% sequence identity to the corresponding regions of other plasmids identified in other countries and isolated from different hosts ( Table S3 ), suggesting that this type of plasmid was widespread dissemination worldwide.…”

“…In this study, we described the genetic environment of bla NDM-5 ( Figure 2 ). It is noteworth that such a genetic environment was found in different plasmids in China, probably indicating that they have a common origin ( Liu et al., 2019 ; Cao et al., 2020 ). Additionally, the genetic environment of bla NDM-5 was similar to those in previously reported clinical K. pneumoniae isolates in India and Spain ( Krishnaraju et al., 2015 ; Pitart et al., 2015 ).…”

Emergence of IncHI2 Plasmid-Harboring blaNDM-5 from Porcine Escherichia coli Isolates in Guangdong, China

“…Until now, bla NDM-5 gene has been reported to be prevalent in various members of Enterobacteriaceae. Recently, plasmid-encoded bla NDM-5 gene was found in Salmonella typhimurium of pork origin [13,14] and Klebsiella pneumonia [4,15] via IncX3 plasmids. IncX3 is a group of narrowhost-range plasmid, with the size of 46,161 bp, and an important transmission vector for bla NDM-5 gene, with a variety of bla NDM-5 subtypes, such as bla NDM-1 , bla NDM-4 , bla NDM-5 , bla NDM-7 and bla NDM-21 [16,17].…”

“…Carbapenems are considered to be the most active and potent agents in the treatment of severe infections caused by multidrug-resistant (MDR) Gram-negative pathogens [ 1 , 2 ]. In the past few years, the emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) has led to a variety of infectious diseases with high mortality rates, which has posed a critical threat to clinical treatment and a public health concern [ 3 , 4 ]. New Delhi metallo-β-lactamase (NDM) is a type of metallo-β-lactamase (MBL) that hydrolyzes most carbapenems except for monobactams [ 5 ].…”

Genomic Investigation and Successful Containment of an Intermittent Common Source Outbreak of OXA-48-Producing Enterobacter cloacae Related to Hospital Shower Drains

“…Besides therapeutic limitations, infections with these pathogens are associated with high morbidity and mortality ( 1 ). Genes encoding carbapenemases are usually located on mobile genetic elements, allowing transfer between organisms, which is a serious public health concern ( 2 , 3 ).…”