title: Colistin-Nonsusceptible Pseudomonas aeruginosa Sequence Type 654 with blaNDM-1 Arrives in North America.
abstract: This study describes 3 different blaNDM-1 genetic platforms in 3 different species obtained from the same patient who was directly transferred to an institution in Calgary, Alberta, Canada, following a prolonged hospital stay in India. The blaNDM-1 in the Escherichia coli isolate was located on a 176-kb IncA/C plasmid contained within an ISCR1 region. The blaNDM-1 in the Providencia rettgeri isolate was located on a 117-kb IncT plasmid contained within Tn3000, while the blaNDM-1 in the Pseudomonas aeruginosa isolate was located on the chromosome within an ISCR3 region. This report highlights the plasticity of the genetic regions and environments associated with blaNDM-1. To the best of our knowledge, this is the first report of P. aeruginosa with blaNDM-1 identified in North America and the first report of blaOXA-181 in P. rettgeri. The P. aeruginosa isolate belonged to the international high-risk sequence type 654 clone and was nonsusceptible to colistin. This case emphasizes the need for the use of appropriate infection prevention and control measures and vigilant screening for carbapenem-resistant Gram-negative bacteria in patients with a history of travel to areas of endemicity, such as the Indian subcontinent.
authors.affiliation: National Microbiology Laboratory, Winnipeg, Manitoba, Canada.
authors.forename: L F
authors.initials: LF
authors.lastname: Mataseje
authors.affiliation: Division of Microbiology, Calgary Laboratory Services, Calgary, Alberta, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Peirano
authors.affiliation: Division of Microbiology, Calgary Laboratory Services, Calgary, Alberta, Canada Department of Pathology & Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: D L
authors.initials: DL
authors.lastname: Church
authors.affiliation: Division of Microbiology, Calgary Laboratory Services, Calgary, Alberta, Canada Department of Pathology & Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Conly
authors.affiliation: National Microbiology Laboratory, Winnipeg, Manitoba, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Mulvey
authors.affiliation: Division of Microbiology, Calgary Laboratory Services, Calgary, Alberta, Canada Department of Pathology & Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa johann.pitout@cls.ab.ca.
authors.forename: J D
authors.initials: JD
authors.lastname: Pitout
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002170:Canada; D015780:Carbapenems / Q000627:therapeutic use; D003091:Colistin / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D004926:Escherichia coli / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D007194:India; D008297:Male; D008826:Microbial Sensitivity Tests; D010957:Plasmids / Q000235:genetics; D011532:Providencia / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D001618:beta-Lactamases; C552864:beta-lactamase NDM-1; D003091:Colistin
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