First case of NDM-1 producing Klebsiella pneumoniae in Caribbean islands.
OBJECTIVE
Characterize a NDM-1 producing K. pneumoniae isolate recovered from a patient hospitalized in Guadeloupe, French West Indies, after its transfer from Cuba


METHODS
Antibiotic susceptibilities were determined by the disk diffusion method, and E-test. Carbapenemase production was assessed using the Carba NP test. Antibiotic resistance determinants and their surrounding structures were characterized by PCR mapping and DNA sequencing. Transfer of the β-lactam resistance marker was attempted by liquid mating-out assays


RESULTS
Here we reported the first NDM-1 producing enterobacterial isolate recovered from Caribbean islands. This K. pneumoniae isolate belongs to a new sequence type (ST1649). The blaNDM-1 gene together with the aacA4 gene were carried on a self conjugative IncR plasmid of c.a. 80kb.


CONCLUSIONS
This study describes the first identification of a NDM-1 producer in Caribbean islands. The uncommon incompatibility group of the blaNDM-1 carrying plasmid and the uncommon ST type of the K. pneumoniae strain suggest a possible local emergence of NDM producers.
University Hospital of Pointe-à-Pitre/Abymes, Pointe-à-Pitre, Guadeloupe, France. Electronic address: sylvaine.bastian@chu-guadeloupe.fr.
Sylvaine
S
Bastian
INSERM U914 « Emerging Resistance to Antibiotic », Le Kremlin-Bicêtre, France; Associated National Reference Center to Antibiotic Resistance, Le Kremlin-Bicêtre, France; University of Fribourg, Fribourg, Switzerland; Hôpital Fribourgeois - Hôpital Cantonal, Fribourg, Switzerland.
Patrice
P
Nordmann
INSERM U914 « Emerging Resistance to Antibiotic », Le Kremlin-Bicêtre, France; Associated National Reference Center to Antibiotic Resistance, Le Kremlin-Bicêtre, France.
Elodie
E
Creton
University Hospital of Pointe-à-Pitre/Abymes, Pointe-à-Pitre, Guadeloupe, France.
Edith
E
Malpote
University Hospital of Pointe-à-Pitre/Abymes, Pointe-à-Pitre, Guadeloupe, France; University of Antilles, Pointe-à-Pitre, Guadeloupe, France.
Guillaume
G
Thiery
University Hospital of Pointe-à-Pitre/Abymes, Pointe-à-Pitre, Guadeloupe, France.
Frederic
F
Martino
University Hospital of Pointe-à-Pitre/Abymes, Pointe-à-Pitre, Guadeloupe, France; University of Antilles, Pointe-à-Pitre, Guadeloupe, France.
Sebastien
S
Breurec
INSERM U914 « Emerging Resistance to Antibiotic », Le Kremlin-Bicêtre, France; Associated National Reference Center to Antibiotic Resistance, Le Kremlin-Bicêtre, France; South Paris University, Faculty of Medecine, Le Kremlin-Bicêtre, France; Assistance Publique des Hôpitaux de Paris, Bicêtre Hospital, Le Kremlin-Bicêtre, France.
Laurent
L
Dortet
D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000235:genetics; D003462:Cuba; D019430:Guadeloupe; D006801:Humans; D007710:Klebsiella Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D008297:Male; D008826:Microbial Sensitivity Tests; D010957:Plasmids / Q000235:genetics / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D014195:Travel; D018440:beta-Lactam Resistance / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics*; D047090:beta-Lactams / Q000494:pharmacology* / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D047090:beta-Lactams; D001618:beta-Lactamases; C552864:beta-lactamase NDM-1; C063912:carbapenemase
Cuba; Guadeloupe; NDM-1; carbapenemase; metallo-β-lactamase