1. Spread of Plasmid-Encoded NDM-1 and GES-5 Carbapenemases among Extensively Drug-Resistant and Pandrug-Resistant Clinical Enterobacteriaceae in Durban, South Africa.
- Author
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Pedersen T, Sekyere JO, Govinden U, Moodley K, Sivertsen A, Samuelsen Ø, Essack SY, and Sundsfjord A
- Subjects
- Anti-Bacterial Agents pharmacology, Bacterial Proteins genetics, Citrobacter freundii drug effects, Citrobacter freundii enzymology, Citrobacter freundii genetics, Enterobacter drug effects, Enterobacter enzymology, Enterobacter genetics, Klebsiella pneumoniae drug effects, Microbial Sensitivity Tests, Phylogeny, Serratia marcescens drug effects, Serratia marcescens enzymology, Serratia marcescens genetics, beta-Lactamases genetics, Bacterial Proteins metabolism, Klebsiella pneumoniae enzymology, Klebsiella pneumoniae genetics, Plasmids genetics, beta-Lactamases metabolism
- Abstract
Whole-genome sequence analyses revealed the presence of bla
NDM-1 ( n = 31), blaGES-5 ( n = 8), blaOXA-232 ( n organisms isolated from in-patients in 10 private hospitals (2012 to 2013) in Durban, South Africa. Two novel NDM-1-encoding plasmids from blaNDM-5 ( n = 1) in extensively drug-resistant and pandrug-resistant Enterobacteriaceae organisms isolated from in-patients in 10 private hospitals (2012 to 2013) in Durban, South Africa. Two novel NDM-1-encoding plasmids from Klebsiella pneumoniae -containing region. The two plasmids were used as references for tracing NDM-1-encoding plasmids in the other genome assemblies. The p19-10_01 sequence was detected in blaNDM-1 was part of a Tn 1548 -like structure (16.276 bp) delineated by IS 26 The multireplicon plasmid p18-43_01 [IncR_1/IncFIB(pB171)/IncFII(Yp); 212.326 bp] shared an 80-kb region with p19-10_01, not including the blaNDM-1 -containing region. The two plasmids were used as references for tracing NDM-1-encoding plasmids in the other genome assemblies. The p19-10_01 sequence was detected in K. pneumoniae ( n = 7) only, whereas p18-43_01 was tracked to K. pneumoniae ( n = 4), Klebsiella michiganensis ( n = 1), Serratia marcescens ( n = 11), Enterobacter spp. ( n = 7), and Citrobacter freundii ( n = 1), revealing horizontal spread of this blaNDM-1 -bearing plasmid structure. Global phylogeny showed clustering of the K. pneumoniae (18/20) isolates together with closely related carbapenemase-negative ST101 isolates from other geographical origins. The South African isolates were divided into three phylogenetic subbranches, where each group had distinct resistance and replicon profiles, carrying either p19-10_01, p18-10_01, or pCHE-A1 (8,201 bp). The latter plasmid carried blaGES-5 and aacA4 within an integron mobilization unit. Our findings imply independent plasmid acquisition followed by local dissemination. Additionally, we detected blaOXA-232 carried by pPKPN4 in K. pneumoniae (ST14) and blaNDM-5 contained by a pNDM-MGR194-like genetic structure in Escherichia coli (ST167), adding even more complexity to the multilayer molecular mechanisms behind nosocomial spread of carbapenem-resistant Enterobacteriaceae in Durban, South Africa., (Copyright © 2018 American Society for Microbiology.)- Published
- 2018
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