Spreading Patterns of NDM-Producing Enterobacteriaceae in Clinical and Environmental Settings in Yangon, Myanmar
| Autor: | Rathina Kumar Shanmugakani, Thuzar Myint, Mya Mya Aye, Isao Nishi, Yukihiro Akeda, Khwar Nyo Zin, Dan Takeuchi, Hideharu Hagiya, Noriko Sakamoto, Kazunori Tomono, Daisuke Motooka, Yo Sugawara, Shigeyuki Hamada |
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| Rok vydání: | 2019 |
| Předmět: |
Klebsiella pneumoniae
Microbial Sensitivity Tests Myanmar medicine.disease_cause beta-Lactamases Epidemiology and Surveillance 03 medical and health sciences Plasmid Bacterial Proteins Drug Resistance Bacterial Enterobacter cloacae Escherichia coli medicine Humans Pharmacology (medical) Gene 030304 developmental biology Pharmacology Genetics 0303 health sciences Whole Genome Sequencing Molecular epidemiology biology 030306 microbiology Enterobacteriaceae Infections Plasmid-mediated resistance biology.organism_classification Enterobacteriaceae Anti-Bacterial Agents Carbapenem-Resistant Enterobacteriaceae Infectious Diseases Carbapenems Horizontal gene transfer Plasmids |
| Zdroj: | Antimicrobial Agents and Chemotherapy. 63 |
| ISSN: | 1098-6596 0066-4804 |
| Popis: | The spread of carbapenemase-producing Enterobacteriaceae (CPE), contributing to widespread carbapenem resistance, has become a global concern. However, the specific dissemination patterns of carbapenemase genes have not been intensively investigated in developing countries, including Myanmar, where NDM-type carbapenemases are spreading in clinical settings. In the present study, we phenotypically and genetically characterized 91 CPE isolates obtained from clinical (n = 77) and environmental (n = 14) samples in Yangon, Myanmar. We determined the dissemination of plasmids harboring genes encoding NDM-1 and its variants using whole-genome sequencing and plasmid analysis. IncFII plasmids harboring bla(NDM-5) and IncX3 plasmids harboring bla(NDM-4) or bla(NDM-7) were the most prevalent plasmid types identified among the isolates. The IncFII plasmids were predominantly carried by clinical isolates of Escherichia coli, and their clonal expansion was observed within the same ward of a hospital. In contrast, the IncX3 plasmids were found in phylogenetically divergent isolates from clinical and environmental samples classified into nine species, suggesting widespread dissemination of plasmids via horizontal transfer. Half of the environmental isolates were found to possess IncX3 plasmids, and this type of plasmid was confirmed to transfer more effectively to recipient organisms at a relatively low temperature (25°C) compared to the IncFII plasmid. Moreover, various other plasmid types were identified harboring bla(NDM-1), including IncFIB, IncFII, IncL/M, and IncA/C(2), among clinical isolates of Klebsiella pneumoniae or Enterobacter cloacae complex. Overall, our results highlight three distinct patterns of the dissemination of bla(NDM)-harboring plasmids among CPE isolates in Myanmar, contributing to a better understanding of their molecular epidemiology and dissemination in a setting of endemicity. |
| Databáze: | OpenAIRE |
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