Multicentre investigation of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in Bulgarian hospitals – Interregional spread of ST11 NDM-1-producing K. pneumoniae

Markovska, Rumyana; Stoeva, Temenuga; Boyanova, Lyudmila; Stankova, Petya; Schneider, Ines; Keuleyan, Emma; Mihova, Kalina; Murdjeva, Marianna; Sredkova, M.; Lesseva, Magdalena; Nedelcheva, Gergana; Petrova, Atanaska; Ivanova, Dobrinka; Lazarova, G.; Kaneva, Radka; Mitov, Ivan

doi:10.1016/j.meegid.2019.01.013

Cited by 17 publications

(17 citation statements)

References 33 publications

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“…First, our results revealed that the main carbapenem resistance mechanism of the CR-EC isolates collected in our hospital could be attributed to the productions of carbapenemases and ESBL/AmpC enzymes combined with porin deficiencies. Notably, while NDM-1 subtype was reported to be the most prevalent from previous studies in China (Tuem et al, 2018;Markovska et al, 2019), NDM-5 was observed to be prevalent among the CR-EC isolates. Most importantly, our study revealed that the most prevalent epidemic incompatibility type of the bla NDM−5 -carrying plasmids in our region is IncF (such as IncFIA, IncFIB, and IncFII), which was substantially different from those reported by the other NDM-5 studies (IncA/C and IncX3-type) (Huang et al, 2016;Li et al, 2018), indicating that a new molecular epidemiological CR-EC will be prevalent in China.…”

Section: Discussionmentioning

confidence: 69%

Emergence of NDM-5-Producing Escherichia coli in a Teaching Hospital in Chongqing, China: IncF-Type Plasmids May Contribute to the Prevalence of blaNDM–5

et al. 2020

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The newly emerging NDM-5 confers increased antibiotic resistance and attracts extensive global attention, but the prevalence, dissemination mechanism, and clinical significance of NDM-5 among clinical Escherichia coli (E. coli) infections have not been thoroughly characterized to date. In the present study, 109 unique carbapenemresistant E. coli (CR-EC) isolates were collected in Southwest China, from 2013 to 2017, among which 41 (37.61%) CR-EC isolates were identified as NDM-5-producers, with most isolates carrying the IncF-type plasmids. Molecular epidemiological studies revealed ST167 being the most common sequence type (ST). Moreover, we described the first report of a clinical CR-EC isolate co-harboring bla KPC−2 and bla NDM−5 , which showed a higher level of resistance to carbapenems. In addition, bla NDM−5 plasmid transformation and conjugation indicated that bla NDM−5 itself did confer resistance to carbapenems. Complete sequencing of the bla NDM−5-harboring IncF plasmid revealed highly conserved regions (ble MBL-trpF-tat) and some transposons around bla NDM−5. Our findings revealed a new potential threat of NDM-5-postive CR-EC in mainland China and emphasized an urgent need to control their further spread.

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Section: Discussionmentioning

confidence: 69%

Emergence of NDM-5-Producing Escherichia coli in a Teaching Hospital in Chongqing, China: IncF-Type Plasmids May Contribute to the Prevalence of blaNDM–5

et al. 2020

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“…The ST11 is a single locus variant of ST258 and a worldwide known high-risk clone for carbapenemases dissemination [25,26]. The presence of bla NDM-1 on ST11 has been previously reported in various world regions, i.e., India, China, Balkan, Bulgaria, and many others [26,27]. The ST11 is classically related to multidrug resistance attainment due to its tendency for harboring multiple plasmids and multiple resistance genes [25,28].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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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.

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“…2014; Markovska et al . 2019), underlining a large spread in Central Europe and in the Balkan region. In Italy, NDM‐producing isolates were associated to diverse STs, including ST11, ST14, ST15, ST16, ST86, ST101, ST147, ST167, ST231, ST235, ST405, ST1067, ST1702, ST3366 and ST3367 (D'Andrea et al .…”

Section: Resultsmentioning

confidence: 99%

New Delhi metallo‐β‐lactamase (NDM‐1)‐producingKlebsiella pneumoniaeof sequence type ST11: first identification in a hospital of central Italy

Ripabelli

Sammarco

Salzo

et al. 2020

Lett. Appl. Microbiol.

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The rapidity by which mechanisms of antibiotic resistance can disseminate following the initial identification or recognition is demonstrated by NDM, which is currently diffused worldwide due to the international transmission, involving movement of infected or colonized individuals. The emergence of NDM in our regional hospital setting, where the circulation of carpabenem resistant Klebsiella pneumoniae is widely sustained, represents a significant public health concern. This study reinforces the importance of monitoring antimicrobial susceptibility and undertaking molecular epidemiology investigations for description of the nature and the type of multidrug resistance in isolates causing hospital infections.

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Multicentre investigation of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in Bulgarian hospitals – Interregional spread of ST11 NDM-1-producing K. pneumoniae

Cited by 17 publications

References 33 publications

Emergence of NDM-5-Producing Escherichia coli in a Teaching Hospital in Chongqing, China: IncF-Type Plasmids May Contribute to the Prevalence of blaNDM–5

Emergence of NDM-5-Producing Escherichia coli in a Teaching Hospital in Chongqing, China: IncF-Type Plasmids May Contribute to the Prevalence of blaNDM–5

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

New Delhi metallo‐β‐lactamase (NDM‐1)‐producingKlebsiella pneumoniaeof sequence type ST11: first identification in a hospital of central Italy

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