Dissemination mechanisms of NDM genes in hospitalized patients.

Autor: Zhai Y; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.; Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, USA., Lee S; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.; Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, USA., Teng L; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.; Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, USA., Ma Z; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.; Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, USA., Hilliard NB; Infection Control, University of Florida Health/Shands Hospital, Gainesville, FL, USA., May RJ; Infection Control, University of Florida Health/Shands Hospital, Gainesville, FL, USA., Brown SA; Infection Control, University of Florida Health/Shands Hospital, Gainesville, FL, USA., Yu F; ICBR, University of Florida, Gainesville, FL, USA., Desear KE; Department of Pharmacy, University of Florida Health/Shands Hospital, Gainesville, FL, USA., Cherabuddi K; Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, Gainesville, FL, USA., Rand KH; Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, Gainesville, FL, USA., Morris JG Jr; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.; Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, Gainesville, FL, USA., Iovine NM; Infection Control, University of Florida Health/Shands Hospital, Gainesville, FL, USA.; Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, Gainesville, FL, USA., Jeong KC; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.; Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, USA.
Jazyk: angličtina
Zdroj: JAC-antimicrobial resistance [JAC Antimicrob Resist] 2021 Mar 30; Vol. 3 (1), pp. dlab032. Date of Electronic Publication: 2021 Mar 30 (Print Publication: 2021).
DOI: 10.1093/jacamr/dlab032
Abstrakt: Background: NDM-producing Enterobacteriaceae are a major clinical concern worldwide. We characterized NDM-positive pathogens isolated from patients and assessed the dissemination patterns of the bla NDM genes in a hospital setting.
Methods: Eleven NDM-positive Enterobacteriaceae (three Enterobacter hormaechei , six Klebsiella pneumoniae and two Escherichia coli ) were isolated from nine patients over a 1 year period. Antimicrobial susceptibility was assessed by MICs. A combination of short- and long-read WGS was used for genome analysis. Clinical treatment history of patients was linked with genetic features of individual isolates to investigate the dissemination patterns of the bla NDM genes and NDM-positive strains.
Results: bla NDM in clonal K. pneumoniae were transmitted between two patients. In other instances, an identical IncC plasmid encoding NDM-1 was transmitted between E. coli and K. pneumoniae isolated from the same patient, and an IncX3 plasmid, carrying bla NDM-1 or bla NDM-5 , was harboured in non-clonal E. hormaechei . Varying patterns of IS elements were identified as a critical transmission mechanism in association with bla NDM genes.
Conclusions: Multiple transmission patterns were identified in hospitalized patients, including dissemination of clonal bacterial strains carrying resistance genes and horizontal transfer of resistance genes among divergent bacterial strains. Controlling spread of NDM is complex: while attention to standard infection control practices is critically important, this needs to be matched by aggressive efforts to limit unnecessary antimicrobial use, to minimize the selection for and risk of transfer of 'high mobility' resistance genes among Enterobacteriaceae.
(© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.)
Databáze: MEDLINE
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