Characterization of NDM-7 Carbapenemase-Producing Escherichia coli Isolates in the Arabian Peninsula.
OBJECTIVE
The purpose of this study was to characterize the New Delhi metallo-beta lactamase (NDM)-7-producing Enterobacteriaceae isolated in the Arabian Peninsula.


METHODS
Enterobacteriaceae identified to carry blaNDM-7in a collection of 157 NDM-producing isolates from Kuwait, Oman, Saudi Arabia, and the United Arab Emirates (UAE) were investigated for their antibiotic and disinfectant susceptibility, and resistance gene content. The virulence profile, phylogenetic and sequence types of the isolates were also determined. The plasmids carrying the blaNDM-7were transferred, and their complete nucleotide sequence was determined.


RESULTS
Four NDM-7-producing Escherichia coli isolated in Kuwait, Oman, and the UAE, respectively, were identified. They were clonally unrelated, carried a few virulence determinants only, and belonged to clonal complexes CC10 and CC23, or ST448. They were all multi-drug resistant but remained susceptible to fosfomycin, tigecycline, and colistin. In all isolates, blaNDM-7was located on IncX3 type plasmids of a variable size, not harboring any further resistance genes. The plasmids exhibited a high degree of similarity to each other and to pKpN01-NDM7 from Canada, with various size deletions and insertions.


CONCLUSIONS
Our findings show that IncX3 type plasmids play an important role in the spread of the currently rare NDM-7 variant in the Arabian Peninsula. This association of blaNDM-7with the IncX3-type plasmid is particularly worrisome, as this type of plasmid was proved to spread other carbapenemases in various species of Enterobacteriaceae worldwide at a high efficiency.
1 Department of Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University , Al Ain, United Arab Emirates .
Tibor
T
Pál
1 Department of Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University , Al Ain, United Arab Emirates .
Akela
A
Ghazawi
1 Department of Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University , Al Ain, United Arab Emirates .
Dania
D
Darwish
2 Department of Infectious Diseases, Istituto Superiore di Sanitá , Rome, Italy .
Laura
L
Villa
2 Department of Infectious Diseases, Istituto Superiore di Sanitá , Rome, Italy .
Alessandra
A
Carattoli
3 Department of Medicine, Tawam Hospital , Al Ain, United Arab Emirates .
Rayhan
R
Hashmey
4 Department of Pathology, Rashid Hospital , Dubai, United Arab Emirates .
Zulfa
Z
Aldeesi
5 Department of Medical Microbiology, Faculty of Medicine, Kuwait University , Kuwait, Kuwait .
Wafaa
W
Jamal
5 Department of Medical Microbiology, Faculty of Medicine, Kuwait University , Kuwait, Kuwait .
Vincent
V
Rotimi
6 Department of Infectious Diseases, Royal Hospital , Muscat, Oman .
Amina
A
Al-Jardani
6 Department of Infectious Diseases, Royal Hospital , Muscat, Oman .
Seif S
SS
Al-Abri
1 Department of Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University , Al Ain, United Arab Emirates .
Ágnes
Á
Sonnevend
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015780:Carbapenems / Q000494:pharmacology; D002999:Clone Cells; D003091:Colistin / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D005578:Fosfomycin / Q000494:pharmacology; D015870:Gene Expression; D006801:Humans; D007730:Kuwait / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D008911:Minocycline / Q000031:analogs & derivatives / Q000494:pharmacology; D058885:Multilocus Sequence Typing; D009850:Oman / Q000453:epidemiology; D010802:Phylogeny; D010957:Plasmids / Q000737:chemistry* / Q000378:metabolism; D012529:Saudi Arabia / Q000453:epidemiology; D000078304:Tigecycline; D014479:United Arab Emirates / Q000453:epidemiology; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism
D000900:Anti-Bacterial Agents; D015780:Carbapenems; D005578:Fosfomycin; D000078304:Tigecycline; D001618:beta-Lactamases; D008911:Minocycline; D003091:Colistin
Escherichia coli; Middle East; NDM-7; carbapenemase; multi-drug resistance