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Recently, Escherichia coli isolates co-producing New Delhi metallo-β-lactamase (NDM)-5 and oxacillinase (OXA)-181 were identified in a tertiary-care hospital of South Korea. Isolate CC1702–1 was collected from urine in January 2017 and isolate CC1706-1 was recovered from a transtracheal aspirate of a hospitalized patient in May 2017. Carbapenemase genes were identified by multiplex PCR and sequencing, and whole genome sequencing was performed subsequently using the PacBio RSII system. Both E. coli isolates belonged to the same clone (ST410) and were resistant to all β-lactams including carbapenems. We obtained whole plasmid sequences of the isolates: pCC1702-NDM-5 from CC1702-1 and pCC1706-NDM-5 and pCC1706-OXA-181 from CC1706-1. The two E. coli isolates belonged to the same clone (ST410) and they were completely resistant to all β -lactams, as well as carbapenems. Two bla NDM-5 -harboring plasmids belonged to the same incompatibility group, IncFIA/B, and consisted of 79,613 bp and 111,890 bp with 87 and 130 coding sequences, respectively. The genetic structures of the two bla NDM-5 -bearing plasmids, which were distinct from the bla NDM-5 -bearing plasmids from the Klebsiella pneumoniae isolates previously transmitted from the United Arab Emirates (UAE) to South Korea, differed from each other. While pCC1702-NDM-5 showed high degree of identity with the plasmid from a multidrug-resistant isolate of Citrobacter fruendii P5571 found in China, pCC1706-NDM-5 was very similar to the plasmid from a multidrug-resistant isolate of E. coli AMA1176 found in Denmark. pCC1706-OXA-181, which was a 51 kb, self-transmissible IncX3 plasmid, was identical to the E. coli plasmids pAMA1167-OXA-181 from Denmark and pOXA-181-WCHEC14828 from China. Plasmids harboring bla NDM-5 in E. coli isolates might not be transferred from K. pneumoniae isolates co-producing NDM-5 and OXA-181. They probably originated from multiple sources. • Escherichia coli isolates co-producing NDM-5 and OXA-181 were identified in a tertiary-care hospital of Korea. • We obtained whole plasmid sequences of an isolate co-producing NDM-5 and OXA-181 and an isolate producing only NDM-5. • Two bla NDM-5 plasmids of E. coli isolates were distinct from those of K. pneumoniae isolates from the UAE and differed from each other. • The bla NDM-5 -bearing plasmids of E. coli isolates explored in this study probably originated from multiple sources. [ABSTRACT FROM AUTHOR]

The two plasmids extracted from Klebsiella pneumoniae sequence type 147 (ST147) isolates were analyzed. The first isolate was obtained from a patient transferred from United Arab Emirates to South Korea. The second isolate was obtained from a Korean patient and was suspected to be transmitted from the first patient. Sequences of two plasmids were almost the same, and genetic structures, including blaNDM-5, of these plasmids were similar to plasmids of NDM-1-producing Escherichia coli ST131 isolates found in Europe., (Copyright © 2016, American Society for Microbiology. All Rights Reserved.)