First report of Escherichia coli co-producing NDM-1 and OXA-232

doi:10.1016/j.diagmicrobio.2016.09.005

Diagnostic Microbiology and Infectious Disease

Volume 86, Issue 4, December 2016, Pages 437-438

https://doi.org/10.1016/j.diagmicrobio.2016.09.005 Get rights and content

Highlights

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First E. coli strain isolated with co-production of NDM-1 and OXA-232
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Carbapenemases are located on two different plasmids.
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blaOXA-232-carrying plasmid identical to previously sequenced ones suggesting high mobility

Abstract

Recently Gram-negative bacteria co-producing multiple carbapenemases have emerged in different parts of the world. We report the first isolation of an Escherichia coli strain co-producing the carbapenemases NDM-1 and OXA-232.

References (11)

F. Al-Marzooq et al.
Emergence of Klebsiella pneumoniae producing dual carbapenemases (NDM-1 and OXA-232) and 16S rRNA methylase (armA) isolated from a Malaysian patient returning from India
Int J Antimicrob Agents
(2015)
A. Bousquet et al.
First case of multidrug-resistant bla_NDM-1- and bla_OXA-232-carrying Klebsiella pneumoniae and its probable cross-transmission in a French hospital
Int J Antimicrob Agents
(2014)
K. Bush
A resurgence of β-lactamase inhibitor combinations effective against multidrug-resistant gram-negative pathogens
Int J Antimicrob Agents
(2015)
A. Potron et al.
Genetic and biochemical characterisation of OXA-232, a carbapenem-hydrolysing class D β-lactamase from enterobacteriaceae
Int J Antimicrob Agents
(2013)
Y. Doi et al.
Co-production of NDM-1 and OXA-232 by Klebsiella pneumoniae
Emerg Infect Dis
(2014)

There are more references available in the full text version of this article.

Cited by (14)

First case of bloodstream infection caused by Mixta hanseatica sp. nov., a novel species within the Mixta genus of the Erwiniaceae family
2023, New Microbes and New Infections
Distribution of β-lactamases and emergence of carbapenemases co-occurring Enterobacterales isolates with high-level antibiotic resistance identified from patients with intra-abdominal infection in the Asia–Pacific region, 2015–2018
2022, Journal of Microbiology, Immunology and Infection
Citation Excerpt :
The co-occurrence of NDM-1/OXA-232 was mainly found in K. pneumoniae, with isolated cases in different countries.32–36 A sporadic case of E. coli harboring both NDM-1/OXA-232 was reported.37 In the absence of selective pressure, plasmids generally impose a fitness cost to host bacteria.
In this study, we aimed to assess the geographic distribution and molecular characteristics of β-lactamases among Enterobacterales isolates causing intra-abdominal infections (IAIs) from 2015 to 2018 in the Asia–Pacific region.
Isolates were investigated for extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases, and carbapenemases using multiplex PCR assays and full-gene DNA sequencing.
A total of 832 Enterobacterales isolates from 8 different countries with β-lactamase genes were analysed. Plasmid-mediated ESBLs and AmpC β-lactamases were encoded in 598 (71.9 %) and 314 (37.7 %) isolates, respectively. In 710 (85.3 %) carbapenemase-negative isolates, positivity for both AmpC β-lactamases and ESBLs was identified in 51 (8.5 %) Escherichia coli and 24 (3.4 %) Klebsiella pneumoniae isolates. The most prevalent countries were Taiwan and Vietnam, and the co-occurrence of CMY/CTX-M in E. coli and DHA-1/ESBLs in K. pneumoniae was predominant. All isolates showed high susceptibility to colistin, but susceptibility to carbapenems varied among different resistance mechanism combinations. Among 122 (14.7 %) isolates encoding carbapenemase, NDM (n = 67, including 64.2 % NDM-1) was the most common, followed by the OXA-48-type (n = 49), KPC (n = 24) and IMP (n = 4). The most prevalent country was Thailand (n = 44), followed by Vietnam (n = 35) and the Philippines (n = 21). Twenty-two isolates were found to encode multiple carbapenemases, 16 of which were collected from Thailand and harbored NDM-1, OXA-232 and CTX-M-15. Despite high susceptibility to amikacin, susceptibility to colistin was only 56 %.
The emergence of carbapenem-non-susceptible AmpC/ESBL co-occurring Enterobacterales and colistin non-susceptible carbapenemases co-occurring K. pneumoniae highlights potential therapeutic challenges in the Asia–Pacific region.
Successful control of the first OXA-48 and/or NDM carbapenemase-producing Klebsiella pneumoniae outbreak in Slovenia 2014–2016
2019, Journal of Hospital Infection
Citation Excerpt :
Co-production of carbapenemases of different classes can complicate treatment as next-generation β-lactam/β-lactamase inhibitor combinations currently available are only suitable for serine carbapenemase and are inactive against metallo-β-lactamases. Co-production of OXA-48 and NDM, which can present a serious treatment challenge, has been described in several studies [22–29]. Slovenia was one of the few countries where CPEs occurred only sporadically and until October 2014 it remained at epidemiological stage 1 [3].
Carbapenemase-producing Enterobacteriaceae (CPE) occur only sporadically in Slovenia.
To describe the first Slovenian carbapenemase-producing (CP) Klebsiella pneumoniae and Escherichia coli outbreak which occurred at the tertiary teaching hospital University Medical Centre Ljubljana from October 2014 to April 2015.
A CPE-positive case was defined as any patient infected or colonized with CPE. A strict definition of a contact patient was adopted. Measures to prevent cross-transmission included cohorting of all CPE carriers with strict contact precautions and assignment of dedicated healthcare workers, cohorting of all contact patients until obtaining the result of screening cultures, systematic rectal screening of contact patients, and tagging of all CPE-positive cases and their contacts. Educational campaigns on CPEs were implemented. Clinical specimens were processed using standard procedures. Pulsed-field gel electrophoresis (PFGE) was used to determine relatedness. Multi-locus sequence typing was performed on CP K. pneumoniae isolates that belonged to different pulsotypes.
Before the outbreak was brought under control, 40 patients were colonized or infected with OXA-48 and/or New Delhi metallo-β-lactamase (NDM)-producing CPE; in 38 patients OXA-48 and/or NDM-producing K. pneumoniae was detected, in seven OXA-48 and/or NDM-producing E. coli was found together with K. pneumoniae, and in two patients only CP E. coli was isolated. The outbreak was oligoclonal with two major CP K. pneumoniae clusters belonging to ST437 and ST147 in epidemiologically linked patients.
Initial standard control measures failed to prevent the outbreak. Once the problem had been recognized, strict infection control measures and the education of healthcare workers contributed to the successful control of the outbreak.
Evolution and typing of IncC plasmids contributing to antibiotic resistance in Gram-negative bacteria
2018, Plasmid
The large, broad host range IncC plasmids are important contributors to the spread of key antibiotic resistance genes and over 200 complete sequences of IncC plasmids have been reported. To track the spread of these plasmids accurate typing to identify the closest relatives is needed. However, typing can be complicated by the high variability in resistance gene content and various typing methods that rely on features of the conserved backbone have been developed. Plasmids can be broadly typed into two groups, type 1 and type 2, using four features that differentiate the otherwise closely related backbones. These types are found in many different countries in bacteria from humans and animals. However, hybrids of type 1 and type 2 are also occasionally seen, and two further types, each represented by a single plasmid, were distinguished. Generally, the antibiotic resistance genes are located within a small number of resistance islands, only one of which, ARI-B, is found in both type 1 and type 2. The introduction of each resistance island generates a new lineage and, though they are continuously evolving via the loss of resistance genes or introduction of new ones, the island positions serve as valuable lineage-specific markers. A current type 2 lineage of plasmids is derived from an early type 2 plasmid but the sequences of early type 1 plasmids include features not seen in more recent type 1 plasmids, indicating a shared ancestor rather than a direct lineal relationship. Some features, including ones essential for maintenance or for conjugation, have been examined experimentally.
Ordering the mob: Insights into replicon and MOB typing schemes from analysis of a curated dataset of publicly available plasmids
2017, Plasmid
Citation Excerpt :
PacBio sequencing technology has clearly been a key driver of the increase in complete plasmid sequences since 2014 (Fig. 1; data prior to 2014 not shown due to a lack of annotation for sequencing technology). The first complete plasmids sequenced using Oxford Nanopore technology were added in June 2016 (Both et al., 2016) and this technology will likely drive further expansion in availability of complete plasmid sequences in future. Sequence topology annotation (circular/linear) was an unreliable indicator of complete plasmid sequences, with 57 of the 2097 curated plasmids annotated as ‘linear’.
Plasmid typing can provide insights into the epidemiology and transmission of plasmid-mediated antibiotic resistance. The principal plasmid typing schemes are replicon typing and MOB typing, which utilize variation in replication loci and relaxase proteins respectively. Previous studies investigating the proportion of plasmids assigned a type by these schemes (‘typeability’) have yielded conflicting results; moreover, thousands of plasmid sequences have been added to NCBI in recent years, without consistent annotation to indicate which sequences represent complete plasmids. Here, a curated dataset of complete Enterobacteriaceae plasmids from NCBI was compiled, and used to assess the typeability and concordance of in silico replicon and MOB typing schemes. Concordance was assessed at hierarchical replicon type resolutions, from replicon family-level to plasmid multilocus sequence type (pMLST)-level, where available. We found that 85% and 65% of the curated plasmids could be replicon and MOB typed, respectively. Overall, plasmid size and the number of resistance genes were significant independent predictors of replicon and MOB typing success. We found some degree of non-concordance between replicon families and MOB types, which was only partly resolved when partitioning plasmids into finer-resolution groups (replicon and pMLST types). In some cases, non-concordance was attributed to ambiguous boundaries between MOBP and MOBQ types; in other cases, backbone mosaicism was considered a more plausible explanation. β-lactamase resistance genes tended not to show fidelity to a particular plasmid type, though some previously reported associations were supported. Overall, replicon and MOB typing schemes are likely to continue playing an important role in plasmid analysis, but their performance is constrained by the diverse and dynamic nature of plasmid genomes.
Characteristics of Enterobacteriaceae Isolates Coharboring Distinct Carbapenemase Genes
2017, Infection Control and Hospital Epidemiology

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¹: These authors contributed equally to this work.

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Diagnostic Microbiology and Infectious Disease

Highlights

Abstract

References (11)

Emergence of Klebsiella pneumoniae producing dual carbapenemases (NDM-1 and OXA-232) and 16S rRNA methylase (armA) isolated from a Malaysian patient returning from India

Int J Antimicrob Agents

First case of multidrug-resistant bla_NDM-1- and bla_OXA-232-carrying Klebsiella pneumoniae and its probable cross-transmission in a French hospital

Int J Antimicrob Agents

A resurgence of β-lactamase inhibitor combinations effective against multidrug-resistant gram-negative pathogens

Int J Antimicrob Agents

Genetic and biochemical characterisation of OXA-232, a carbapenem-hydrolysing class D β-lactamase from enterobacteriaceae

Int J Antimicrob Agents

Co-production of NDM-1 and OXA-232 by Klebsiella pneumoniae

Emerg Infect Dis

Cited by (14)

First case of bloodstream infection caused by Mixta hanseatica sp. nov., a novel species within the Mixta genus of the Erwiniaceae family

Distribution of β-lactamases and emergence of carbapenemases co-occurring Enterobacterales isolates with high-level antibiotic resistance identified from patients with intra-abdominal infection in the Asia–Pacific region, 2015–2018

Successful control of the first OXA-48 and/or NDM carbapenemase-producing Klebsiella pneumoniae outbreak in Slovenia 2014–2016

Evolution and typing of IncC plasmids contributing to antibiotic resistance in Gram-negative bacteria

Ordering the mob: Insights into replicon and MOB typing schemes from analysis of a curated dataset of publicly available plasmids

Characteristics of Enterobacteriaceae Isolates Coharboring Distinct Carbapenemase Genes

Antimicrobial Susceptibility StudiesFirst report of Escherichia coli co-producing NDM-1 and OXA-232

Highlights

Abstract

Int J Antimicrob Agents

Int J Antimicrob Agents

Int J Antimicrob Agents

Int J Antimicrob Agents

Co-production of NDM-1 and OXA-232 by Klebsiella pneumoniae

Emerg Infect Dis

Antimicrobial Susceptibility Studies
First report of Escherichia coli co-producing NDM-1 and OXA-232