First Report of blaNDM-1 Bearing IncX3 Plasmid in Clinically Isolated ST11 Klebsiella pneumoniae from Pakistan

Abstract

The New Delhi Metallo-β-lactamase (NDM) is among the most threatening forms of carbapenemases produced by K. pneumoniae, well-known to cause severe worldwide infections. The molecular epidemiology of blaNDM-1-harboring K. pneumoniae is not well elucidated in Pakistan. Herein, we aim to determine the antibiotics-resistance profile, genes type, molecular type, and plasmid analysis of 125 clinically isolated K. pneumoniae strains from urine samples during July 2018 to January 2019 in Pakistan. A total of 34 (27.2%) K. pneumoniae isolates were carbapenemases producers, and 23 (18.4%) harbored the blaNDM-1 gene. The other carbapenemases encoding genes, i.e., blaIMP-1 (7.2%), blaVIM-1 (3.2%), and blaOXA-48 (2.4%) were also detected. The Multi Locus Sequence Typing (MLST) results revealed that all blaNDM-1-harboring isolates were ST11. The other sequence types detected were ST1, ST37, and ST105. The cluster analysis of Xbal Pulsed Field Gel Electrophoresis (PFGE) revealed variation amongst the clusters of the identical sequence type isolates. The blaNDM-1 gene in all of the isolates was located on a 45-kb IncX3 plasmid, successfully transconjugated. For the first time, blaNDM-1-bearing IncX3 plasmids were identified from Pakistan, and this might be a new primary vehicle for disseminating blaNDM-1 in Enterobacteriaceae as it has a high rate of transferability.

Genomic Epidemiology of Carbapenemase-Producing and Colistin-Resistant Enterobacteriaceae among Sepsis Patients in Ethiopia: a Whole-Genome Analysis

“…Plasmid incompatibility (Inc) groups IncC, IncHI, IncF, IncR, and IncX3 were identified among carbapenem-resistant K. pneumoniae isolates, where the plasmid IncF group was the most frequent type and included IncFIA(HI1), IncFIB(K), IncFIB(K) (pCAV1099-114), IncFIB(pQil), IncFIB(pKPHS1), IncFII, IncFII(K), and IncFII(pKP91). Several studies showed similar findings ( 8 , 14 , 40 , 41 ). Even if all strains described here carry multiple plasmids, not all bla NDM-1 genes could be unambiguously assigned to a particular plasmid.…”

Antimicrobial resistance among GLASS priority pathogens from Pakistan: 2006–2018

“…Reports of high levels of antibacterial resistance [ 4 – 7 ] from hospitals as well as the community [ 8 , 9 ] in Pakistan, the fifth most populous country globally [ 10 ], places an additional burden on an overstressed and under resourced health care system. Circulating mobile genetic elements in bacterial species [ 5 , 7 , 11 ] that can transfer multidrug resistance genes within and between species have also been reported. Further, the detection of extensively drug resistant (XDR) Salmonella Typhi from Hyderabad, Pakistan [ 12 ] reinforces concerns over the complex interaction between environment and anthropogenic activities in contributing towards emerging AMR.…”

Unraveling the Diversity of Co-Colonization by CPE

“…In this case, an outbreak was caused by a clonally related bla NDM7 -producing E. coli strain, transmitted between six patients and leading to their colonization. Most noteworthy in Case Study 3, however, is the clear evidence of HGT, which occurred in patient E. The rapid global spread of bla NDM in different bacterial species is extensively reported in the literature, because this gene is carried on a broad host range of conjugative plasmids [ 28 , 29 ]. Here, we discuss two cases of HGT occurring between distinct bacterial species that were very likely mediated by a plasmid: (1) bla NDM-7 was transferred between IncX3-carrying E. coli and K. aerogenes (Case 3) and (2) bla NDM-1 was transferred between K. oxytoca and E. cloacae (Case 2), both carrying IncX3.…”