title: New Delhi metallo-β-lactamase-producing Enterobacteriaceae, United States.
abstract: We characterized 9 New Delhi metallo-β-lactamase-producing Enterobacteriaceae (5 Klebsiella pneumoniae, 2 Escherichia coli, 1 Enterobacter cloacae, 1 Salmonella enterica serovar Senftenberg) isolates identified in the United States and cultured from 8 patients in 5 states during April 2009-March 2011. Isolates were resistant to β-lactams, fluoroquinolones, and aminoglycosides, demonstrated MICs ≤1 µg/mL of colistin and polymyxin, and yielded positive metallo-β-lactamase screening results. Eight isolates had blaNDM-1, and 1 isolate had a novel allele (blaNDM-6). All 8 patients had recently been in India or Pakistan, where 6 received inpatient health care. Plasmids carrying blaNDM frequently carried AmpC or extended spectrum β-lactamase genes. Two K. pneumoniae isolates and a K. pneumoniae isolate from Sweden shared incompatibility group A/C plasmids with indistinguishable restriction patterns and a common blaNDM fragment; all 3 were multilocus sequence type 14. Restriction profiles of the remaining New Delhi metallo-β-lactamase plasmids, including 2 from the same patient, were diverse.
authors.affiliation: Antimicrobial Resistance and Characterization Laboratory, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop G08, Atlanta, GA 30329, USA. jkr1@cdc.gov
authors.forename: J Kamile
authors.initials: JK
authors.lastname: Rasheed
authors.forename: Brandon
authors.initials: B
authors.lastname: Kitchel
authors.forename: Wenming
authors.initials: W
authors.lastname: Zhu
authors.forename: Karen F
authors.initials: KF
authors.lastname: Anderson
authors.forename: Nancye C
authors.initials: NC
authors.lastname: Clark
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Ferraro
authors.forename: Patrice
authors.initials: P
authors.lastname: Savard
authors.forename: Romney M
authors.initials: RM
authors.lastname: Humphries
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Kallen
authors.forename: Brandi M
authors.initials: BM
authors.lastname: Limbago
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D004755:Enterobacteriaceae / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000378:metabolism*; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D058885:Multilocus Sequence Typing; D010802:Phylogeny; D010957:Plasmids / Q000235:genetics; D017422:Sequence Analysis, DNA; D014481:United States / Q000453:epidemiology; D018440:beta-Lactam Resistance / Q000235:genetics; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases; C552864:beta-lactamase NDM-1
keywords: Enterobacteriaceae; NDM; New Delhi metallo-β-lactamase; United States; antimicrobial resistance; bacteria; carbapenem resistance; carbapenemase