Emergence of New Delhi Metallo-β-Lactamase (NDM-5) in <italic toggle="yes">Klebsiella quasipneumoniae</italic> from Neonates in a Nigerian Hospital

ABSTRACT Outbreaks of infection occur more often than they are reported in most developing countries, largely due to poor diagnostic services. A Klebsiella species bacteremia outbreak in a newborn unit with high mortality was recently encountered at a location being surveilled for childhood bacterem...

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Autores principales:	Lauren M. Brinkac, Richard White, Roshan D’Souza, Kevin Nguyen, Stephen K. Obaro, Derrick E. Fouts
Formato:	article
Lenguaje:	EN
Publicado:	American Society for Microbiology 2019
Materias:	ESBL Enterobacteriaceae Klebsiella New Delhi metallo-β-lactamase (NDM-5) Nigeria antimicrobial resistance Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/31e9405bd3224f329ab1527fa7a2ff3f
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spelling	oai:doaj.org-article:31e9405bd3224f329ab1527fa7a2ff3f2021-11-15T15:22:22ZEmergence of New Delhi Metallo-β-Lactamase (NDM-5) in <italic toggle="yes">Klebsiella quasipneumoniae</italic> from Neonates in a Nigerian Hospital10.1128/mSphere.00685-182379-5042https://doaj.org/article/31e9405bd3224f329ab1527fa7a2ff3f2019-04-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mSphere.00685-18https://doaj.org/toc/2379-5042ABSTRACT Outbreaks of infection occur more often than they are reported in most developing countries, largely due to poor diagnostic services. A Klebsiella species bacteremia outbreak in a newborn unit with high mortality was recently encountered at a location being surveilled for childhood bacteremia. These surveillance efforts offered the opportunity to determine the cause of this neonatal outbreak. In this report, we present the whole-genome sequences of New Delhi metallo-β-lactamase (NDM-5)-containing Klebsiella quasipneumoniae subsp. similipneumoniae bloodstream isolates from a neonatal bacteremia outbreak at a tertiary hospital in Nigeria and as part of the largest collection of K. pneumoniae bloodstream isolates from children in Africa. Comparative analysis of the genetic environment surrounding the NDM-5 genes revealed nearly perfect sequence identity to blaNDM-5-bearing IncX3-type plasmids from other members of the Enterobacteriaceae. IMPORTANCE Carbapenem-resistant Klebsiella pneumoniae is of global health importance, yet there is a paucity of genome-based studies in Africa. Here we report fatal blood-borne NDM-5-producing K. quasipneumoniae subsp. similipneumoniae infections from Nigeria, Africa. New Delhi metallo-β-lactamase (NDM)-producing Klebsiella spp. are responsible for high mortality and morbidity, with the NDM-5 variant showing elevated carbapenem resistance. The prevalence of NDM-5 in Klebsiella has been limited primarily to K. pneumoniae, with only one isolate being collected from Africa. During an outbreak of sepsis in a teaching hospital in Nigeria, five NDM-5-producing K. quasipneumoniae subsp. similipneumoniae sequence type 476 isolates were identified. Given the increased resistance profile of these strains, this study highlights the emerging threat of blaNDM-5 dissemination in hospital environments. The observation of these NDM-5-producing isolates in Africa stresses the urgency to improve monitoring and clinical practices to reduce or prevent the further spread of resistance.Lauren M. BrinkacRichard WhiteRoshan D’SouzaKevin NguyenStephen K. ObaroDerrick E. FoutsAmerican Society for MicrobiologyarticleESBLEnterobacteriaceaeKlebsiellaNew Delhi metallo-β-lactamase (NDM-5)Nigeriaantimicrobial resistanceMicrobiologyQR1-502ENmSphere, Vol 4, Iss 2 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	ESBL Enterobacteriaceae Klebsiella New Delhi metallo-β-lactamase (NDM-5) Nigeria antimicrobial resistance Microbiology QR1-502
spellingShingle	ESBL Enterobacteriaceae Klebsiella New Delhi metallo-β-lactamase (NDM-5) Nigeria antimicrobial resistance Microbiology QR1-502 Lauren M. Brinkac Richard White Roshan D’Souza Kevin Nguyen Stephen K. Obaro Derrick E. Fouts Emergence of New Delhi Metallo-β-Lactamase (NDM-5) in <italic toggle="yes">Klebsiella quasipneumoniae</italic> from Neonates in a Nigerian Hospital
description	ABSTRACT Outbreaks of infection occur more often than they are reported in most developing countries, largely due to poor diagnostic services. A Klebsiella species bacteremia outbreak in a newborn unit with high mortality was recently encountered at a location being surveilled for childhood bacteremia. These surveillance efforts offered the opportunity to determine the cause of this neonatal outbreak. In this report, we present the whole-genome sequences of New Delhi metallo-β-lactamase (NDM-5)-containing Klebsiella quasipneumoniae subsp. similipneumoniae bloodstream isolates from a neonatal bacteremia outbreak at a tertiary hospital in Nigeria and as part of the largest collection of K. pneumoniae bloodstream isolates from children in Africa. Comparative analysis of the genetic environment surrounding the NDM-5 genes revealed nearly perfect sequence identity to blaNDM-5-bearing IncX3-type plasmids from other members of the Enterobacteriaceae. IMPORTANCE Carbapenem-resistant Klebsiella pneumoniae is of global health importance, yet there is a paucity of genome-based studies in Africa. Here we report fatal blood-borne NDM-5-producing K. quasipneumoniae subsp. similipneumoniae infections from Nigeria, Africa. New Delhi metallo-β-lactamase (NDM)-producing Klebsiella spp. are responsible for high mortality and morbidity, with the NDM-5 variant showing elevated carbapenem resistance. The prevalence of NDM-5 in Klebsiella has been limited primarily to K. pneumoniae, with only one isolate being collected from Africa. During an outbreak of sepsis in a teaching hospital in Nigeria, five NDM-5-producing K. quasipneumoniae subsp. similipneumoniae sequence type 476 isolates were identified. Given the increased resistance profile of these strains, this study highlights the emerging threat of blaNDM-5 dissemination in hospital environments. The observation of these NDM-5-producing isolates in Africa stresses the urgency to improve monitoring and clinical practices to reduce or prevent the further spread of resistance.
format	article
author	Lauren M. Brinkac Richard White Roshan D’Souza Kevin Nguyen Stephen K. Obaro Derrick E. Fouts
author_facet	Lauren M. Brinkac Richard White Roshan D’Souza Kevin Nguyen Stephen K. Obaro Derrick E. Fouts
author_sort	Lauren M. Brinkac
title	Emergence of New Delhi Metallo-β-Lactamase (NDM-5) in <italic toggle="yes">Klebsiella quasipneumoniae</italic> from Neonates in a Nigerian Hospital
title_short	Emergence of New Delhi Metallo-β-Lactamase (NDM-5) in <italic toggle="yes">Klebsiella quasipneumoniae</italic> from Neonates in a Nigerian Hospital
title_full	Emergence of New Delhi Metallo-β-Lactamase (NDM-5) in <italic toggle="yes">Klebsiella quasipneumoniae</italic> from Neonates in a Nigerian Hospital
title_fullStr	Emergence of New Delhi Metallo-β-Lactamase (NDM-5) in <italic toggle="yes">Klebsiella quasipneumoniae</italic> from Neonates in a Nigerian Hospital
title_full_unstemmed	Emergence of New Delhi Metallo-β-Lactamase (NDM-5) in <italic toggle="yes">Klebsiella quasipneumoniae</italic> from Neonates in a Nigerian Hospital
title_sort	emergence of new delhi metallo-β-lactamase (ndm-5) in <italic toggle="yes">klebsiella quasipneumoniae</italic> from neonates in a nigerian hospital
publisher	American Society for Microbiology
publishDate	2019
url	https://doaj.org/article/31e9405bd3224f329ab1527fa7a2ff3f
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Emergence of New Delhi Metallo-β-Lactamase (NDM-5) in <italic toggle="yes">Klebsiella quasipneumoniae</italic> from Neonates in a Nigerian Hospital

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