The First Report of Escherichia coli and Klebsiella pneumoniae Strains That Produce Both NDM-5 and OXA-181 in Jiangsu Province, China

Abstract

Objective The aim of this study was to analyze the genetic characteristics of three Enterobacteriaceae strains (one strain of Escherichia coli and two strains of Klebsiella pneumoniae ) that produce both the NDM-5 and OXA-181 carbapenemases in pediatric patients. Methods Carbapenem-resistant Enterobacteriaceae (CRE) strains were collected from the Children’s Hospital Affiliated to Nanjing Medical University in 2022. Resistance genes were detected by PCR. CRE strains that produced both the bla NDM-5 and bla OXA-181 genes were further characterized by antimicrobial susceptibility testing, multilocus sequence typing (MLST), plasmid conjugation assay, S1 nuclease-PFGE, Southern blotting and whole-genome sequencing. Results Three Enterobacteriaceae strains carrying both the bla NDM-5 and bla OXA-181 resistance genes were screened. MLST results showed that the strain of Escherichia coli carrying both bla NDM-5 and bla OXA-181 was ST410; the two strains of Klebsiella pneumoniae with both bla NDM-5 and bla OXA-181 were ST2601 and ST759. Conjugation assays showed that the plasmids harboring the bla NDM-5 and bla OXA-181 genes were self-transmissible. S1-PFGE and Southern blotting showed that the bla NDM-5 and bla OXA-181 genes were located on the plasmid with the size of about 60kb~. The genotyping results showed that the plasmid types were ColKP3 and IncX3. Conclusion This is the first report of Enterobacteriaceae strains that produce both NDM-5 and OXA-181 isolated from pediatric patients in China. Active infection control measures are urgently needed to prevent the spread of bacteria in children.

Molecular characterization of carbapenem and ceftazidime-avibactam-resistant Enterobacterales and horizontal spread of blaNDM-5 gene at a Lebanese medical center

“…The detection of bla NDM-5 positive isolates raises significant concerns due to its potent ability to break down a broad spectrum of β-lactam antibiotics, including carbapenems. Recognized globally for its contribution to antibiotic resistance ( Daaboul et al., 2023 ; Linkevicius et al., 2023 ; Simner et al., 2023 ; Tao et al., 2023 ), the prevalence of bla NDM-5 underscores the urgent challenge it poses to treating bacterial infections. The concurrent presence of bla NDM-5 and bla OXA-48 in our strains severely limits treatment options with last-resort antibiotics like ceftazidime-avibactam.…”

Table_2.xlsx

“…The detection of bla NDM-5 positive isolates raises significant concerns due to its potent ability to break down a broad spectrum of b-lactam antibiotics, including carbapenems. Recognized globally for its contribution to antibiotic resistance (Daaboul et al, 2023;Linkevicius et al, 2023;Simner et al, 2023;Tao et al, 2023), the prevalence of bla NDM-5 underscores the urgent challenge it poses to treating bacterial infections. The concurrent presence of bla NDM-5 and bla OXA-48 in our strains severely limits treatment options with last-resort antibiotics like ceftazidime-avibactam.…”

Table_3.xlsx

“…The detection of bla NDM-5 positive isolates raises significant concerns due to its potent ability to break down a broad spectrum of b-lactam antibiotics, including carbapenems. Recognized globally for its contribution to antibiotic resistance (Daaboul et al, 2023;Linkevicius et al, 2023;Simner et al, 2023;Tao et al, 2023), the prevalence of bla NDM-5 underscores the urgent challenge it poses to treating bacterial infections. The concurrent presence of bla NDM-5 and bla OXA-48 in our strains severely limits treatment options with last-resort antibiotics like ceftazidime-avibactam.…”