NDM-4- and NDM-5-Producing Klebsiella pneumoniae Coinfection in a 6-Month-Old Infant

Khalifa, Hazim O.; Soliman, Ahmed M.; Ahmed, Ashraf M.; Shimamoto, Tadashi

doi:10.1128/aac.00479-16

Cited by 30 publications

(22 citation statements)

References 10 publications

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“…The most prevalent NDM variants in K. pneumoniae is bla NDM−4 , followed by bla NDM−5 and bla NDM−1 (Figure 3 ). It has also been shown in earlier studies in Klebsiella pneumonia (Khalifa et al, 2016 ; Petersen-Morfin et al, 2017 ). Of 18 NDM producing K. pneumoniae , 6 were NDM-1 isolates, coexisting with bla OXA−1 , bla OXA−9 , bla SHV−1 , bla CMY−1 , and bla CMY−145.…”

Section: Discussionsupporting

confidence: 76%

Occurrence of blaNDM Variants Among Enterobacteriaceae From a Neonatal Intensive Care Unit in a Northern India Hospital

et al. 2018

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Carbapenem-resistance among enterobacteriaceae has become a global health concern. The objective of this study was to understand NDM producing enterobacteriaceae and their genetic basis of resistance, spreading in neonatal intensive care unit. Carbapenem resistant NDM producing enterobacteriaceae isolates were recovered from rectal swab and blood sample of infants admitted in NICU. These were determined by using Carba-NP test. All isolates were identified using BD PhoenixTM−100 and MICs were determined by broth microdilution method. The blaNDM and associated resistant markers were checked by PCR followed by sequencing. Moreover, ERIC-PCR and genetic environment of blaNDM gene were also performed for the analysis of clonal relationship and genetic surrounding of the strains. We characterized 44 isolates with blaNDM variants in Escherichia coli (45.5%), Klebsiella pneumoniae (40.9%), Citrobacter freundii (4.5%), Citrobacter braakii (2.3%), Klebsiella oxytoca (2.3%), Enterobacter cloacae (2.3%), Enterobacter aerogenes (2.2%) from NICU, showing resistance against all antibiotics except colistin and polymixin B. ISAba125 and bleomycin gene were found surrounding all blaNDM variants, besides class I integron on plasmid. (ERIC)-PCR data revealed non-clonal relatedness among most of the isolates. The transfer of resistant markers was confirmed by conjugation experiment. The PCR-based replicon typing was carried out using DNA of transconjugants. These isolates carried NDM-1 (20.45%), NDM-4 (36.36%), NDM-5 (38.64%), NDM-7 (4.55%), along with OXA, CMY, and SHV variants on conjugative plasmid of IncFIA, IncFIC, IncF, IncK, IncFIB, IncB/O, IncHI1, IncP, IncY, IncFIIA, IncI1, and IncN types. An increased number of carbapenem-resistant NDM producing enterobacteriaceae isolates recovered from NICU which is alarming signal for health workers and policy makers. Hence, it is utmost important to think about infection control measures.

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Section: Discussionsupporting

confidence: 76%

Occurrence of blaNDM Variants Among Enterobacteriaceae From a Neonatal Intensive Care Unit in a Northern India Hospital

et al. 2018

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“…4 Several recent studies revealed that the bla NDM-4 gene was carried by plasmids belonging to different replicon types, including F, FII, L/M and X3 in E. coli and K. pneumoniae ; however, only two partial sequences of IncFII plasmids (accession NO KP826711 and KP826707) and one partial sequence of an IncX3 plasmid (accession NO KP826709) except pJEG027 are available for the genetic context of bla NDM-4 . 2, 3, 13 The second completely sequenced bla NDM-4 carrying plasmid pEC55-NDM-4, in our study, is nearly identical to the first characterized bla NDM-1 -harboring IncX3 plasmid pNDM-HN380, further suggesting that bla NDM-4 might have emerged on IncX3 plasmids via a point mutation in bla NDM-1 . The occurrence of a pNDM-HN380-like plasmid carrying bla NDM-4, in this study, together with recent observations of IncX3-type plasmids carrying different bla NDM alleles, including bla NDM-1 (pNDM-HN380), bla NDM-4 (pJEG027), bla NDM-5 (pNDM_MGR194, pNDM5_0215 and pEc1929), and bla NDM-7 (pEC50-NDM7), in different countries (Austria, India, China and Canada) and different species ( K. pneumoniae , E. coli , Serratia marcescens, and Enterobacter hormaechei ), 4, 12, 14, 15 strongly indicates that IncX3 plasmids, which have a narrow host range in Enterobacteriaceae , might have played a major role in the rapid global dissemination of NDM-type MBLs among Enterobacteriaceae .…”

supporting

confidence: 67%

First identification of NDM-4-producing Escherichia coli ST410 in China

Qin

Zhou

Zhang

et al. 2016

Emerging Microbes & Infections

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“…bla NDM-4 has been found on plasmids of IncF 22 , 24 , IncK 25 , IncL/M 26 or IncX3 27 , 28 . However, the complete sequence of IncF plasmids carrying bla NDM-4 is not available for comparison.…”

Section: Resultsmentioning

confidence: 99%

Cryptic transmission of ST405 Escherichia coli carrying bla NDM-4 in hospital

Zhang

Feng

McNally

et al. 2018

Sci Rep

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Three carbapenem-resistant Escherichia coli were recovered from rectal swabs of different patients in a tertiary hospital and were found carrying bla NDM-4, an uncommon bla NDM variant. Genome sequences of the isolates were obtained using Illumina technology and the long-read MinION sequencer. The isolates belonged to ST405 and phylogenetic group D, a globally distributed lineage associated with antimicrobial resistance. In addition to bla NDM-4, the three isolates carried 14 known resistance genes including the extended-spectrum β-lactamase gene bla CTX-M-15. There were only 1 or 2 SNPs between the isolates, suggesting a common origin and cryptic transmission in hospital. bla NDM-4 was located on a 46.5-kb IncFIA self-transmissible plasmid, which may facilitate further dissemination of bla NDM-4. Two copies of IS26 bracketed a 14.6-kb region containing bla NDM-4 and have the potential to form a composite transposon for mediating the mobilization of bla NDM-4.

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NDM-4- and NDM-5-Producing Klebsiella pneumoniae Coinfection in a 6-Month-Old Infant

Cited by 30 publications

References 10 publications

Occurrence of blaNDM Variants Among Enterobacteriaceae From a Neonatal Intensive Care Unit in a Northern India Hospital

Occurrence of blaNDM Variants Among Enterobacteriaceae From a Neonatal Intensive Care Unit in a Northern India Hospital

First identification of NDM-4-producing Escherichia coli ST410 in China

Cryptic transmission of ST405 Escherichia coli carrying bla NDM-4 in hospital

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