blaNDM-1 Carriage on IncR Plasmid in Enterobacteriaceae Strains.
Four NDM-1-producing Enterobacteriaceae strains (three Klebsiella pneumoniae and one Citrobacter koseri) were isolated between 2009 and 2011 through a nationwide surveillance for carbapenem-resistant Enterobacteriaceae in Croatia to study the molecular genetic background of blaNDM and the responsible plasmid types. Phenotypically, the clinical strains proved to be multidrug resistant. All strains remained susceptible to tigecycline and colistin. The clinical strains harbored variable antibiotic resistance determinants, notably, blaNDM-1, blaTEM-1, blaSHV-1, blaSHV-12, blaOXA-1, blaOXA-9, blaCTX-M-15, blaCMY-4, qnrB1, and aac(6')Ib-cr in different combinations. Two K. pneumoniae belonged to sequence type ST15 and one strain to ST16. As for the plasmid types, C. koseri and one of the ST15 K. pneumoniae carried IncR, and the second ST15 K. pneumoniae carried IncR and colE. The K. pneumoniae ST16 strain hosted A/C and colE plasmids. The blaNDM-1 gene was detected on conjugative high-molecular-weight plasmids, namely, A/C and IncR types. It is noteworthy that this is the first description of K. pneumoniae ST16 expressing NDM-1 in Europe. Remarkably, our study underscores the importance of the IncR plasmid as a reservoir of multidrug resistance. To the best of our knowledge, the IncR plasmid carrying blaNDM-1 in C. koseri is reported for the first time.
1 Department of Diagnostics and Public Health, University of Verona , Verona, Italy .|2 Institute of Medical Microbiology, Semmelweis University , Budapest, Hungary .
Erika
E
Kocsis
3 Department of Clinical Microbiology, University Hospital for Infectious Diseases , Zagreb, Croatia .
Marija
M
Gužvinec
3 Department of Clinical Microbiology, University Hospital for Infectious Diseases , Zagreb, Croatia .
Iva
I
Butić
4 Institute of Public Health , Bjelovar, Croatia .
Sanja
S
Krešić
5 Department of Clinical Microbiology and Hospital Infections, University Hospital Dubrava , Zagreb, Croatia .
Sandra Šestan
SŠ
Crnek
3 Department of Clinical Microbiology, University Hospital for Infectious Diseases , Zagreb, Croatia .
Arjana
A
Tambić
1 Department of Diagnostics and Public Health, University of Verona , Verona, Italy .
Giuseppe
G
Cornaglia
1 Department of Diagnostics and Public Health, University of Verona , Verona, Italy .
Annarita
A
Mazzariol
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015780:Carbapenems / Q000494:pharmacology; D041041:Citrobacter koseri / Q000187:drug effects / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D003091:Colistin / Q000494:pharmacology; D003227:Conjugation, Genetic; D017523:Croatia; D004269:DNA, Bacterial / Q000235:genetics*; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000382:microbiology; D015870:Gene Expression; D022761:Gene Transfer, Horizontal; D006801:Humans; D007527:Isoenzymes / Q000235:genetics / Q000378:metabolism; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D008911:Minocycline / Q000031:analogs & derivatives / Q000494:pharmacology; D010957:Plasmids / Q000737:chemistry / Q000378:metabolism*; D017422:Sequence Analysis, DNA; D000078304:Tigecycline; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism
D000900:Anti-Bacterial Agents; D015780:Carbapenems; D004269:DNA, Bacterial; D007527:Isoenzymes; D000078304:Tigecycline; D001618:beta-Lactamases; C552864:beta-lactamase NDM-1; D008911:Minocycline; D003091:Colistin