Emergence of an NDM-5-Producing Escherichia coli Sequence Type 410 Clone in Infants in a Children’s Hospital in China
| Autor: | Yong Mei Hu, Hai Jian Zhou, Jian Long Liu, Ming Xiang Zou, Hai Chen Wang, Xiao Yan Tao, Ting Yu, Jun Li |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Pharmacology Sulfamethoxazole 030106 microbiology Outbreak Tigecycline Biology bacterial infections and mycoses Trimethoprim Microbiology 03 medical and health sciences 0302 clinical medicine Infectious Diseases Amikacin medicine Colistin Pulsed-field gel electrophoresis Multilocus sequence typing Pharmacology (medical) 030212 general & internal medicine medicine.drug |
| Zdroj: | Infection and Drug Resistance. 13:703-710 |
| ISSN: | 1178-6973 |
| DOI: | 10.2147/idr.s244874 |
| Popis: | Purpose Outbreaks of infection due to carbapenem-resistant Enterobacterales (CRE), including New Delhi metallo-β-lactamase (NDM)-producing Escherichia coli, have been increasingly reported worldwide, primarily in adults and rarely in children. The goal of this study was to characterize an outbreak of infection caused by NDM-5-producing E. coli in a children's hospital in China. Methods A total of 86 CRE isolates were collected from 85 hospitalized children between June 2017 and May 2018. These isolates were subjected to multiple phenotypic and molecular tests, including in vitro antimicrobial susceptibility testing, PCR, pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and whole-genome sequencing (WGS). Results Among the 86 CRE isolates, we identified 9 NDM-5-producing E. coli isolates, with 5 of them sharing the same PFGE pattern, same MLST type (ST410), same plasmid replicon type (IncFII), and nearly the same set of additional resistance genes. All 9 isolates were resistant to most antimicrobial agents, including carbapenems, cephalosporins, and levofloxacin, while being sensitive to trimethoprim/sulfamethoxazole, amikacin, tigecycline, and colistin. According to the clinical background, all 9 isolates were collected in a period of < 3 months from infants among whom there was overlap in the time of hospitalization. None of them had a travel history. Conclusion Our analysis suggests an outbreak of clonal dissemination, presumably due to nosocomial transmission. This study represents the first documented outbreak of NDM-5-producing E. coli mediated by IncFII in infants. Close monitoring is urgently needed to prevent and control the spread of this difficult-to-treat superbug. |
| Databáze: | OpenAIRE |
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