Veterinary Microbiology and Preventive Medicine
Journal or Book Title
Antimicrobial Agents and Chemotherapy
The emergence and spread of New Delhi metallo-β-lactamase 1 (NDM-1)-producing carbapenem-resistant Enterobacteriaceae (CRE) present an urgent threat to human health. In China, the blaNDM-1 gene has been reported mostly in Acinetobacter spp. but is rarely found in Enterobacteriaceae. Here, we report a high incidence and endemic spread of NDM-1-producing CRE in Henan Province in China. Sixteen (33.3%) of the 48 CRE isolates obtained from patients during June 2011 to July 2012 were positive for blaNDM-1, and the gene was found to be carried on plasmids of various sizes (∼55 to ∼360 kb). These plasmids were readily transferrable to recipient Escherichia coli by conjugation, conferred resistance to multiple antibiotics, and belonged to multiple replicon types. The blaNDM-1-positive CRE isolates were genetically diverse, and six new multilocus sequence typing (MLST) sequence types were linked to the carriage of NDM-1. Five of the isolates were classified as extensively drug-resistant (XDR) isolates, four of which also carried the fosA3 gene conferring resistance to fosfomycin, an alternative drug for treating infections by CRE. In each blaNDM-1-positive CRE isolate, the blaNDM-1 gene was downstream of an intact ISAba125 element and upstream of the bleMBL gene. Furthermore, gene environment analysis suggested the possible transmission of blaNDM-1-containing sequences from Acinetobacter spp. to Klebsiella pneumoniae and Klebsiella oxytoca. These findings reveal the emergence and active transmission of NDM-1-positive CRE in China and underscore the need for heightened measures to control their further spread.
American Society for Microbiology
Qin, Shangshang; Fu, Ying; Zhang, Qijing; Qi, Hui; Wen, Jian Guo; Xu, Hui; Xu, Lijuan; Zeng, Li; Tian, Hao; Rong, Lijuan; Li, Yonghong; Shan, Lihong; Xu, Hongde; Yu, Yunsong; Feng, Xianju; and Liu, Hong-Min, "High Incidence and Endemic Spread of NDM-1-Positive Enterobacteriaceae in Henan Province, China" (2014). Veterinary Microbiology and Preventive Medicine Publications. 155.