Emergence of Klebsiella pneumoniae co-producing NDM-type and OXA-181 carbapenemases

Abstract

The emergence of carbapenemase-producing Enterobacteriaceae is a rapidly evolving threat worldwide. Here, we report the molecular characterization of two Klebsiella pneumoniae isolates carrying both bla(OXA -181) and bla(NDM -1) or bla(NDM -5) isolated from epidemiologically unrelated patients in Singapore. The bla(OXA -181) genes were found existing in different genetic environments.

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

“…Since then, OXA-181-producing Enterobacteriaceae were reported in several other countries on the Indian subcontinent, including Bangladesh, Sri Lanka, and Nepal (16,17), followed by Canada, France, the Netherlands, New Zealand (in a K. pneumoniae isolate from a patient from Nepal), Norway (in a patient from Romania), Oman, Romania, Singapore, South Africa, and the United Kingdom (in a patient from India) (18).…”

“…A K. pneumoniae isolate belonging to the same ST type (ST147) and carrying an IncFII plasmid with bla OXA-181 and bla NDM-5 was previously reported in South Korea from a patient transferred from a tertiary care hospital in Abu Dhabi, United Arab Emirates (29). However, the first report of a K. pneumoniae isolate harboring bla OXA-181 and bla NDM-5 occurred in Singapore in 2013 and was isolated from the urine of a patient that was transferred from Bangladesh (16). Another isolate harboring both carbapenemase genes was described in Egypt; however, it was an E. coli that carried each gene on a different plasmid (30).…”

First Report of OXA-181-Producing Escherichia coli in China and Characterization of the Isolate Using Whole-Genome Sequencing

“…To our knowledge, this is the first report of OXA-181 in China. Since the identification of OXA-181 in India in 2007, OXA-181-producing Enterobacteriaceae has been reported from several other countries in the Indian subcontinent, i.e., Bangladesh (9) and Sri Lanka (10) and potentially Nepal, as a Nepalese patient hospitalized in New Zealand was found to be carrying an OXA-181-producing K. pneumoniae (11). Outside the subcontinent, Enterobacteriaceae isolates producing OXA-181 have been found in Canada (12), France (13), the Netherlands (14), New Zealand (in a patient from Nepal) (11), Norway (in a patient from Romania) (15), Oman (16), Romania (17), Singapore (9), South Africa (18), and United Kingdom (in a patient from India) (19).…”

“…The only exception was in a Citrobacter freundii strain; bla NDM-1 was not detected on the plasmid carrying bla OXA-181 , suggesting that bla NDM-1 is likely located on a different plasmid. It would be interesting to explore whether bla NDM-1 was located on an IncX3 plasmid within those strains carrying bla NDM-1 and bla OXA-181 (9,10,12,(15)(16)(17)29). On the other hand, as WCHEC14828 has no bla NDM-1 , it may also be possible that an IncX3 plasmid carrying bla OXA-181 has replaced the IncX3 plasmid carrying bla NDM-1 due to plasmid incompatibility.…”

In Vitro Activities of Ceftazidime-Avibactam, Aztreonam-Avibactam, and a Panel of Older and Contemporary Antimicrobial Agents against Carbapenemase-Producing Gram-Negative Bacilli

“…These consisted of 172 Enterobacteriaceae isolates (107 KPC, 32 NDM, 8 OXA-48, 4 OXA-181, 2 OXA-232, 5 IMI, 3 SME, and 11 IMP producers) and 5 Pseudomonas aeruginosa isolates (4 VIM producers and 1 KPC producer). Genotypic characterization was performed using PCR/sequencing as previously described (7)(8)(9)(10)(11)(12)(13)(14)(15). All CP-GNB isolates tested positive by the CarbaNP test (16), except for one isolate each of OXA-181 and OXA-232, which were CarbaNP negative, and one OXA-48-producing isolate, which was CarbaNP indeterminate.…”