Dissemination of the <italic toggle="yes">bla</italic><sub>NDM-5</sub> Gene via IncX3-Type Plasmid among <italic toggle="yes">Enterobacteriaceae</italic> in Children

ABSTRACT The continuous emergence of novel New Delhi metallo-β-lactamase-5 (NDM-5)-producing Enterobacteriaceae isolates is receiving more and more public attention. Twenty-two NDM-5-producing strains were identified from 146 carbapenemase-producing Enterobacteriaceae (CRE) strains isolated from ped...

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Autores principales: Dongxing Tian, Bingjie Wang, Hong Zhang, Fen Pan, Chun Wang, Yingying Shi, Yan Sun
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Lenguaje:EN
Publicado: American Society for Microbiology 2020
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Acceso en línea:https://doaj.org/article/f30203f8da20423297fac103381af244
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id oai:doaj.org-article:f30203f8da20423297fac103381af244
record_format dspace
institution DOAJ
collection DOAJ
language EN
topic NDM-5
Enterobacteriaceae
ST48
IncX3-type plasmid
carbapenemase
children
Microbiology
QR1-502
spellingShingle NDM-5
Enterobacteriaceae
ST48
IncX3-type plasmid
carbapenemase
children
Microbiology
QR1-502
Dongxing Tian
Bingjie Wang
Hong Zhang
Fen Pan
Chun Wang
Yingying Shi
Yan Sun
Dissemination of the <italic toggle="yes">bla</italic><sub>NDM-5</sub> Gene via IncX3-Type Plasmid among <italic toggle="yes">Enterobacteriaceae</italic> in Children
description ABSTRACT The continuous emergence of novel New Delhi metallo-β-lactamase-5 (NDM-5)-producing Enterobacteriaceae isolates is receiving more and more public attention. Twenty-two NDM-5-producing strains were identified from 146 carbapenemase-producing Enterobacteriaceae (CRE) strains isolated from pediatric patients between January and March 2017, indicating that the blaNDM-5 gene has spread to children. All 22 isolates, including 16 Klebsiella pneumoniae strains, four Klebsiella aerogenes strains, and two Escherichia coli strains, showed significantly high resistance to β-lactam antibiotics (except aztreonam) but remained susceptible to tigecycline and colistin. K. pneumoniae and K. aerogenes strains were respectively defined as homologous clonal isolates by pulsed-field gel electrophoresis (PFGE). Multilocus sequence typing (MLST) results confirmed the genetic relatedness with all K. pneumoniae strains belonging to sequence type (ST) 48. Two E. coli isolates (ST617 and ST1236) were considered genetically unrelated. Twenty-two blaNDM-5 plasmids were positive for the IncX3 amplicon and showed almost identical profiles after digestion with HindIII and EcoRI. Four representative strains (K. pneumoniae K725, K. aerogenes CR33, E. coli Z214, and E. coli Z244) were selected for further study. Plasmids harboring blaNDM-5 showed strong stability in both clinical isolates and transconjugants, without apparent plasmid loss after 100 serial generations. S1-PFGE followed by Southern blot analysis demonstrated that the blaNDM-5 gene was located on an ∼46-kb plasmid. Plasmid sequences of pNDM-K725, pNDM-CR33, and pNDM-Z214 were almost identical but were slightly different from that of pNDM-Z244. Compared with pNDM-Z244, ΔISAba125 and partial copies of IS3000 were missing. The genetic backgrounds of the blaNDM-5 gene in four strains were slightly different from that of the typical pNDM_MGR194. This study comprehensively characterized the horizontal gene transfer of the blaNDM-5 gene among different Enterobacteriaceae isolates in pediatric patients, and the IncX3-type plasmid was responsible for the spread. IMPORTANCE The emergence of CRE strains resistant to multiple antibiotics is considered a substantial threat to human health. Therefore, all the efforts to provide a detailed molecular transmission mechanism of specific drug resistance can contribute positively to prevent the further spread of multidrug-resistant bacteria. Although the new superbug harboring blaNDM-5 has been reported in many countries, it was mostly identified among E. coli strains, and the gene transfer mechanism has not been fully recognized and studied. In this work, we identified 22 blaNDM-5-positive strains in different species of Enterobacteriaceae, including 16 Klebsiella pneumoniae strains, four Klebsiella aerogenes strains, and two Escherichia coli strains, which indicated the horizontal gene transfer of blaNDM-5 among Enterobacteriaceae strains in pediatric patients. Moreover, blaNDM-5 was located on a 46-kb IncX3 plasmid, which is possibly responsible for this widespread horizontal gene transfer. The different genetic contexts of the blaNDM-5 gene indicated some minor evolutions of the plasmid, based on the complete sequences of the blaNDM-5 plasmids. These findings are of great significance to understand the transmission mechanism of drug resistance genes, develop anti-infection treatment, and take effective infection control measures.
format article
author Dongxing Tian
Bingjie Wang
Hong Zhang
Fen Pan
Chun Wang
Yingying Shi
Yan Sun
author_facet Dongxing Tian
Bingjie Wang
Hong Zhang
Fen Pan
Chun Wang
Yingying Shi
Yan Sun
author_sort Dongxing Tian
title Dissemination of the <italic toggle="yes">bla</italic><sub>NDM-5</sub> Gene via IncX3-Type Plasmid among <italic toggle="yes">Enterobacteriaceae</italic> in Children
title_short Dissemination of the <italic toggle="yes">bla</italic><sub>NDM-5</sub> Gene via IncX3-Type Plasmid among <italic toggle="yes">Enterobacteriaceae</italic> in Children
title_full Dissemination of the <italic toggle="yes">bla</italic><sub>NDM-5</sub> Gene via IncX3-Type Plasmid among <italic toggle="yes">Enterobacteriaceae</italic> in Children
title_fullStr Dissemination of the <italic toggle="yes">bla</italic><sub>NDM-5</sub> Gene via IncX3-Type Plasmid among <italic toggle="yes">Enterobacteriaceae</italic> in Children
title_full_unstemmed Dissemination of the <italic toggle="yes">bla</italic><sub>NDM-5</sub> Gene via IncX3-Type Plasmid among <italic toggle="yes">Enterobacteriaceae</italic> in Children
title_sort dissemination of the <italic toggle="yes">bla</italic><sub>ndm-5</sub> gene via incx3-type plasmid among <italic toggle="yes">enterobacteriaceae</italic> in children
publisher American Society for Microbiology
publishDate 2020
url https://doaj.org/article/f30203f8da20423297fac103381af244
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spelling oai:doaj.org-article:f30203f8da20423297fac103381af2442021-11-15T15:27:53ZDissemination of the <italic toggle="yes">bla</italic><sub>NDM-5</sub> Gene via IncX3-Type Plasmid among <italic toggle="yes">Enterobacteriaceae</italic> in Children10.1128/mSphere.00699-192379-5042https://doaj.org/article/f30203f8da20423297fac103381af2442020-02-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mSphere.00699-19https://doaj.org/toc/2379-5042ABSTRACT The continuous emergence of novel New Delhi metallo-β-lactamase-5 (NDM-5)-producing Enterobacteriaceae isolates is receiving more and more public attention. Twenty-two NDM-5-producing strains were identified from 146 carbapenemase-producing Enterobacteriaceae (CRE) strains isolated from pediatric patients between January and March 2017, indicating that the blaNDM-5 gene has spread to children. All 22 isolates, including 16 Klebsiella pneumoniae strains, four Klebsiella aerogenes strains, and two Escherichia coli strains, showed significantly high resistance to β-lactam antibiotics (except aztreonam) but remained susceptible to tigecycline and colistin. K. pneumoniae and K. aerogenes strains were respectively defined as homologous clonal isolates by pulsed-field gel electrophoresis (PFGE). Multilocus sequence typing (MLST) results confirmed the genetic relatedness with all K. pneumoniae strains belonging to sequence type (ST) 48. Two E. coli isolates (ST617 and ST1236) were considered genetically unrelated. Twenty-two blaNDM-5 plasmids were positive for the IncX3 amplicon and showed almost identical profiles after digestion with HindIII and EcoRI. Four representative strains (K. pneumoniae K725, K. aerogenes CR33, E. coli Z214, and E. coli Z244) were selected for further study. Plasmids harboring blaNDM-5 showed strong stability in both clinical isolates and transconjugants, without apparent plasmid loss after 100 serial generations. S1-PFGE followed by Southern blot analysis demonstrated that the blaNDM-5 gene was located on an ∼46-kb plasmid. Plasmid sequences of pNDM-K725, pNDM-CR33, and pNDM-Z214 were almost identical but were slightly different from that of pNDM-Z244. Compared with pNDM-Z244, ΔISAba125 and partial copies of IS3000 were missing. The genetic backgrounds of the blaNDM-5 gene in four strains were slightly different from that of the typical pNDM_MGR194. This study comprehensively characterized the horizontal gene transfer of the blaNDM-5 gene among different Enterobacteriaceae isolates in pediatric patients, and the IncX3-type plasmid was responsible for the spread. IMPORTANCE The emergence of CRE strains resistant to multiple antibiotics is considered a substantial threat to human health. Therefore, all the efforts to provide a detailed molecular transmission mechanism of specific drug resistance can contribute positively to prevent the further spread of multidrug-resistant bacteria. Although the new superbug harboring blaNDM-5 has been reported in many countries, it was mostly identified among E. coli strains, and the gene transfer mechanism has not been fully recognized and studied. In this work, we identified 22 blaNDM-5-positive strains in different species of Enterobacteriaceae, including 16 Klebsiella pneumoniae strains, four Klebsiella aerogenes strains, and two Escherichia coli strains, which indicated the horizontal gene transfer of blaNDM-5 among Enterobacteriaceae strains in pediatric patients. Moreover, blaNDM-5 was located on a 46-kb IncX3 plasmid, which is possibly responsible for this widespread horizontal gene transfer. The different genetic contexts of the blaNDM-5 gene indicated some minor evolutions of the plasmid, based on the complete sequences of the blaNDM-5 plasmids. These findings are of great significance to understand the transmission mechanism of drug resistance genes, develop anti-infection treatment, and take effective infection control measures.Dongxing TianBingjie WangHong ZhangFen PanChun WangYingying ShiYan SunAmerican Society for MicrobiologyarticleNDM-5EnterobacteriaceaeST48IncX3-type plasmidcarbapenemasechildrenMicrobiologyQR1-502ENmSphere, Vol 5, Iss 1 (2020)