Characterization of an IncN2-type blaNDM-1-carrying plasmid in Escherichia coli ST131 and Klebsiella pneumoniae ST11 and ST15 isolates in Thailand

Netikul, Thidarat; Sidjabat, Hanna E.; Paterson, David L.; Kamolvit, Witchuda; Tantisiriwat, Woraphot; Steen, Jason A.; Kiratisin, Pattarachai

doi:10.1093/jac/dku275

Cited by 48 publications

(42 citation statements)

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“…Geographically specific dissemination of bla NDM by a certain group of plasmid types has been previously reported with five identical IncN2 plasmids harboring bla NDM in four K. pneumoniae and one E. coli ST131 isolates in two countries in Southeast Asia (13,14). The characterization presented here would indeed help to track the horizontal movement of bla NDM among members of the family Enterobacteriaceae.…”

Section: Resultssupporting

confidence: 57%

“…Genetic variations in the accessory regions of plasmids have contributed to the complexity that underlies the spread of antimicrobial resistance determinants between bacterial hosts. Since its first description (5), bla NDM has been reported on various plasmid Inc types (6), including IncA/C (7,8), IncF types (9), IncL/M (10), IncH (11), IncN types (12)(13)(14), IncX types (15), and IncHI1 types (16), of the family Enterobacteriaceae. However, it may be misleading to assume that all plasmids of the same replicon type are identical, especially among the IncA/C (7,(17)(18)(19) and IncFII (9,20) plasmids.…”

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confidence: 99%

“…The bla NDM genetic contexts of NDM producers from Singapore, Japan, Hong Kong, Thailand, and Taiwan have been described (10,(12)(13)(14)18). Additionally, NDM-producing Enterobacteriaceae have been reported in Australia (27,28).…”

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confidence: 99%

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Genomic Characteristics of NDM-Producing Enterobacteriaceae Isolates in Australia and Their bla _NDM Genetic Contexts

Wailan

Paterson

Kennedy

et al. 2016

Antimicrob Agents Chemother

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e bla NDM has been reported in different Enterobacteriaceae species and on numerous plasmid replicon types (Inc). Plasmid replicon typing, in combination with genomic characteristics of the bacterial host (e.g., sequence typing), is used to infer the spread of antimicrobial resistance determinants between genetically unrelated bacterial hosts. The genetic context of bla NDM is heterogeneous. In this study, we genomically characterized 12 NDM-producing Enterobacteriaceae isolated in Australia between 2012 and 2014: Escherichia coli (n ‫؍‬ 6), Klebsiella pneumoniae (n ‫؍‬ 3), Enterobacter cloacae (n ‫؍‬ 2) and Providencia rettgeri (n ‫؍‬ 1). We describe their bla NDM genetic contexts within Tn125, providing insights into the acquisition of bla NDM into Enterobacteriaceae. IncFII-type (n ‫؍‬ 7) and IncX3 (n ‫؍‬ 4) plasmids were the most common plasmid types found. The IncHI1B (n ‫؍‬ 1) plasmid was also identified. Five different bla NDM genetic contexts were identified, indicating four particular plasmids with specific bla NDM genetic contexts (NGCs), three of which were IncFII plasmids (FII-A to -C). Of note, the bla NDM genetic context of P. rettgeri was not conjugative. Epidemiological links between our NDM-producing Enterobacteriaceae were established by their acquisition of these five particular plasmid types. The combination of different molecular and genetic characterization methods allowed us to provide insight into the spread of plasmids transmitting bla NDM .

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confidence: 57%

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confidence: 99%

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Genomic Characteristics of NDM-Producing Enterobacteriaceae Isolates in Australia and Their bla _NDM Genetic Contexts

Wailan

Paterson

Kennedy

et al. 2016

Antimicrob Agents Chemother

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“…ASM authors also retain the right to reuse the full article in his/her dissertation or thesis. The blaNDM genetic context of NDM-producers from Singapore, Japan, Hong Kong, Thailand and Taiwan has been described (74,125,177,203,224). Additionally, NDM-producing…”

Section: Acknowledgmentsmentioning

confidence: 99%

“…However, it may be misleading to assume that each plasmid of the same replicon type is identical, especially amongst the IncA/C (94,175,177,205) and IncFII plasmids (182,202 The blaNDM genetic context of NDM-producers from Singapore, Japan, Hong Kong, Thailand and Taiwan has been described (74,125,177,203,224). Additionally, NDM-producing…”

Section: Acknowledgmentsmentioning

confidence: 99%

The genetic analysis of Enterobacteriaceae plasmids to provide insights into the acquisition and spread of the blaNDM gene

Wailan¹

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Treatment options for infections caused by pathogenic Gram-negative bacteria, especially those of the Enterobacteriaceae family, are becoming limited with the increase of antimicrobial resistance (AMR). β-lactamases are a major mechanism for AMR within the Enterobacteriaeae. The most problematic β-lactamases are carbapenemases, which confer resistance to carbapenems, the major last-line antimicrobial. A recently emerged carbapenemase that has globally disseminated is the NDM carbapenemase, provided by blaNDM genes. These blaNDM genes (and other AMR genes) are able to transmit between strains when inserted on extrachromosomal self-replicating DNA molecules known as 'plasmids'. AMR genes within Enterobacteriacae are frequently associated with specific bacterial species, clonal lineage, plasmid Incompatibility (Inc) types or transposable elements. The blaNDM genes however do not have this association when oberserved in the Enterobacteriaceae family. To address and characterise this new paradigm presented by blaNDM genes, this thesis presents the bioinformatic analysis of plasmids associated with the Enterobacteriaceae to provide insights into the acquisition and spread of the blaNDM gene and an epidemiological approach to assess its plasmid-mediated dissemination between genetically unrelated species.Specifically these aims were achieved by; firstly, the establishment of a recent account of the blaNDM gene from an epidemiological perspective using a novel genetic/molecular approach. This would identify the spread of individual plasmids carrying blaNDM across multiple species and patients, both within a single facility and across multiple national facilities. The approach combined in-depth bioinformatic analysis of blaNDM genetic contexts (NGCs) with common molecular epidemiology techniques. IncN2 (n=4) and IncA/C (n=3) were identified as the most common plasmids types carrying blaNDM across four patients within a Pakistani military hospital. These patients harboured between two and four NDM-1 producing Gram-negative bacilli of different ii species coresident in their stool samples. IncFII-types (n=7) and IncX3 (n=4) were the most common plasmid types carrying blaNDM amongst 12 Enterobacteriaceae isolates, each from different patients across multiple Australian healthcare facilities. These isolates each carried one plasmid harbouring blaNDM but only five different blaNDM genetic contexts were identified, indicating five particular plasmids with a specific NGC had disseminated amongst these 12 isolates.Secondly, to investigate transposable elements involved for insertion of the blaNDM gene into different plasmid types, the complete sequence of four plasmids carrying blaNDM (two IncA/C2 and two IncFIIY) was bioinformatically analysed. These plasmids were from four different clinical samples of four patients, comprised of Klebsiella pneumoniae, Enterobacter cloacae, and Escherichia coli. Each plasmid was observed to acquire blaNDM by different mechanisms on very similar plasmid backbones. Transposable elements ...

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Prevalence and risk factors for intestinal carriage of CTX-M-type ESBLs in Enterobacteriaceae from a Thai community

Niumsup

Tansawai

Na-udom

et al. 2017

Eur J Clin Microbiol Infect Dis

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The incidence of infections caused by antimicrobial-resistant Enterobacteriaceae in Thailand is increasing and human intestinal flora is an important reservoir for these organisms. This study was carried out to determine the intestinal carriage of bla extended spectrum ß-lactamase-positive Enterobacteriaceae (ESBL + E) and AmpC-positive Enterobacteriaceae in a community setting in Northern Thailand, and to identify potential risk factors for carriage. A total of 307 fecal samples were collected from healthy volunteers in Phitsanulok province, and cefotaxime-resistant Enterobacteriaceae (CtxRE) were isolated using selective media. Polymerase chain reaction (PCR) was used to detect ESBL and AmpC genes. Risk factors were analyzed using multiple logistic regression. Genotyping was performed by multilocus sequence typing (MLST) analysis. Two hundred ninety-one CtxRE isolates were obtained and Escherichia coli was the predominant organism (66.3%). The intestinal carriage rates of bla ESBL + E and AmpC-positive Enterobacteriaceae were 52.1% and 6.2%, respectively. Comparative levels of bla and bla were found while bla was the predominant genotype among AmpC genes. Co-existence of two ß-lactamase genes in a single isolate was found in 6.5% of isolates. Consumption of undercooked meat was strongly associated with intestinal carriage of bla ESBL + E (p = 0.003, OR = 2.133, 95% CI = 1.289-3.530). Phylogenetic grouping and MLST analysis of E. coli isolates revealed the presence of E. coli B2-ST131 (n = 8). Of these, seven carried bla and 1 carried bla. Our results suggest that residents in Thailand are at high risk for developing endogenous infections caused by antibiotic-resistant Enterobacteriaceae.

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Characterization of an IncN2-type blaNDM-1-carrying plasmid in Escherichia coli ST131 and Klebsiella pneumoniae ST11 and ST15 isolates in Thailand

Cited by 48 publications

References 10 publications

Genomic Characteristics of NDM-Producing Enterobacteriaceae Isolates in Australia and Their bla _NDM Genetic Contexts

Genomic Characteristics of NDM-Producing Enterobacteriaceae Isolates in Australia and Their bla _NDM Genetic Contexts

The genetic analysis of Enterobacteriaceae plasmids to provide insights into the acquisition and spread of the blaNDM gene

Prevalence and risk factors for intestinal carriage of CTX-M-type ESBLs in Enterobacteriaceae from a Thai community

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Characterization of an IncN2-type blaNDM-1-carrying plasmid in Escherichia coli ST131 and Klebsiella pneumoniae ST11 and ST15 isolates in Thailand

Cited by 48 publications

References 10 publications

Genomic Characteristics of NDM-Producing Enterobacteriaceae Isolates in Australia and Their bla NDM Genetic Contexts

Genomic Characteristics of NDM-Producing Enterobacteriaceae Isolates in Australia and Their bla NDM Genetic Contexts

The genetic analysis of Enterobacteriaceae plasmids to provide insights into the acquisition and spread of the blaNDM gene

Prevalence and risk factors for intestinal carriage of CTX-M-type ESBLs in Enterobacteriaceae from a Thai community

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Product

Resources

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Genomic Characteristics of NDM-Producing Enterobacteriaceae Isolates in Australia and Their bla _NDM Genetic Contexts

Genomic Characteristics of NDM-Producing Enterobacteriaceae Isolates in Australia and Their bla _NDM Genetic Contexts