Genetic Plurality of OXA/NDM-Encoding Features Characterized From Enterobacterales Recovered From Czech Hospitals

Abstract

The aim of this study was to characterize four Enterobacterales co-producing NDM- and OXA-48-like carbapenemases from Czech patients with travel history or/and previous hospitalization abroad. Klebsiella pneumoniae isolates belonged to “high risk” clones ST147, ST11, and ST15, while the Escherichia coli isolate was assigned to ST167. All isolates expressed resistance against most β-lactams, including carbapenems, while retaining susceptibility to colistin. Furthermore, analysis of WGS data showed that all four isolates co-produced OXA-48- and NDM-type carbapenemases, in different combinations (Kpn47733: blaNDM–5 + blaOXA–181; Kpn50595: blaNDM–1 + blaOXA–181; Kpn51015: blaNDM–1 + blaOXA–244; Eco52418: blaNDM–5 + blaOXA–244). In Kpn51015, the blaOXA–244 was found on plasmid p51015_OXA-244, while the respective gene was localized in the chromosomal contig of E. coli Eco52418. On the other hand, blaOXA–181 was identified on a ColKP3 plasmid in isolate Kpn47733, while a blaOXA–181-carrying plasmid being an IncX3-ColKP3 fusion was identified in Kpn50595. The blaNDM–1 gene was found on two different plasmids, p51015_NDM-1 belonging to a novel IncH plasmid group and p51015_NDM-1 being an IncFK1-FIB replicon. Furthermore, the blaNDM–5 was found in two IncFII plasmids exhibiting limited nucleotide similarity to each other. In both plasmids, the genetic environment of blaNDM–5 was identical. Finally, in all four carbapenemase-producing isolates, a diverse number of additional replicons, some of these associated with important resistance determinants, like blaCTX–M–15, arr-2 and ermB, were identified. In conclusion, this study reports the first description of OXA-244-producing Enterobacterales isolated from Czech hospitals. Additionally, our findings indicated the genetic plurality involved in the acquisition and dissemination of determinants encoding OXA/NDM carbapenemases.

Anatomy of an extensively drug-resistant Klebsiella pneumoniae outbreak in Tuscany, Italy

“…Furthermore, we also confirm the early concern about cross-border spread ( 17 ), as highly genetically related isolates and/or near-identical plasmids ( SI Appendix , Fig. S3 ) are detected in emerging, convergent K. pneumoniae from hospitals around the globe ( 6 , 14 , 16 , 22 , 33 ).…”

OXA-484, an OXA-48-Type Carbapenem-Hydrolyzing Class D β-Lactamase From Escherichia coli

“…The highly similar sequences between the IncX3 plasmids harboring bla OXA – 484 and bla OXA – 181 including the IS Ecp1 elements and two AT-rich direct target repeats bracketing bla OXA – 484 suggest the same mechanism of mobilization for bla OXA – 484 . The spread of OXA-181 and OXA-232 has additionally been associated with specific high-risk clones like ST101, ST307 and ST15 for K. pneumoniae and ST38 and ST410 for E. coli ( Cubero et al, 2015 ; Li et al, 2019 ; Pitout et al, 2019 ; Chudejova et al, 2021 ). Notably, the E. coli isolate JS316 belongs to the high-risk ST410, which has been identified as a worldwide distributed extraintestinal pathogenic E. coli lineage causing nosocomial outbreaks ( Roer et al, 2018 ; Patiño-Navarrete et al, 2020 ).…”

“…In contrast, bla OXA – 181 is primarily found on a 51.5 kb IncX3 plasmid and has been associated with IS Ecp1 in a Tn 2013 transposon structure, whereas bla OXA – 232 is commonly located on a non-conjugative 6.1 kb ColE-type plasmid ( Qin et al, 2018 ; Li et al, 2019 ). In case of bla OXA – 244 , the gene is mostly identified on the chromosome of E. coli and has been increasingly identified in the European Union in recent years ( European Centre for Disease Prevention and Control, 2020 ; Kremer et al, 2020 ; Chudejova et al, 2021 ).…”

A transferrable IncL/M plasmid harboring a gene encoding IMP-1 metallo-β-lactamase in clinical isolates of Enterobacteriaceae

“…Few reports have described the in vitro and in vivo horizontal transfer of identical carbapenemase-encoding plasmids [13][14][15][16]. This study describes a patient infected with three species of Enterobacteriaceae, all of which carried a transferrable IncL/M plasmid producing IMP-1.…”