Characterization of NDM-Encoding Plasmids From Enterobacteriaceae Recovered From Czech Hospitals

Veronika Paskova; Matej Medvecky; Anna Skalova; Katerina Chudejova; Ibrahim Bitar; Vladislav Jakubu; Tamara Bergerova; Helena Zemlickova; Costas C Papagiannitsis; Jaroslav Hrabak

doi:10.3389/fmicb.2018.01549

Characterization of NDM-Encoding Plasmids From Enterobacteriaceae Recovered From Czech Hospitals

Front Microbiol. 2018 Jul 10:9:1549. doi: 10.3389/fmicb.2018.01549. eCollection 2018.

Authors

Veronika Paskova^{1

2}, Matej Medvecky^{3

4}, Anna Skalova^{1

2}, Katerina Chudejova^{1

2}, Ibrahim Bitar^{1

2}, Vladislav Jakubu⁵, Tamara Bergerova^{1

2}, Helena Zemlickova^{5

6}, Costas C Papagiannitsis^{1

2}, Jaroslav Hrabak^{1

2}

Affiliations

¹ Department of Microbiology, Faculty of Medicine and University Hospital in Plzen, Charles University, Plzen, Czechia.
² Faculty of Medicine, Biomedical Center, Charles University, Plzen, Czechia.
³ Veterinary Research Institute, Brno, Czechia.
⁴ Faculty of Science, National Centre for Biomolecular Research, Masaryk University, Brno, Czechia.
⁵ National Reference Laboratory for Antibiotics, National Institute of Public Health, Prague, Czechia.
⁶ Department of Clinical Microbiology, University Hospital and Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czechia.

Abstract

The aim of the present study was to characterize sporadic cases and an outbreak of NDM-like-producing Enterobacteriaceae recovered from hospital settings, in Czechia. During 2016, 18 Entrobacteriaceae isolates including 10 Enterobacter cloacae complex (9 E. xiangfangensis and 1 E. asburiae), 4 Escherichia coli, 1 Kluyvera intermedia, 1 Klebsiella pneumoniae, 1 Klebsiella oxytoca, and 1 Raoultella ornithinolytica that produced NDM-like carbapenemases were isolated from 15 patients. Three of the patients were colonized or infected by two different NDM-like producers. Moreover, an NDM-4-producing isolate of E. cloacae complex, isolated in 2012, was studied for comparative purposes. All isolates of E. cloacae complex, except the E. asburiae, recovered from the same hospital, were assigned to ST182. Additionally, two E. coli belonged to ST167, while the remaining isolates were not clonally related. Thirteen isolates carried bla_NDM-4, while six isolates carried bla_NDM-1 (n = 3) or bla_NDM-5 (n = 3). Almost all isolates carried bla_NDM-like-carrying plasmids being positive for the IncX3 allele, except ST58 E. coli and ST14 K. pneumoniae isolates producing NDM-1. Analysis of plasmid sequences revealed that all IncX3 bla_NDM-like-carrying plasmids exhibited a high similarity to each other and to previously described plasmids, like pNDM-QD28, reported from worldwide. However, NDM-4-encoding plasmids differed from other IncX3 plasmids by the insertion of a Tn3-like transposon. On the other hand, the ST58 E. coli and ST14 K. pneumoniae isolates carried two novel NDM-1-encoding plasmids, pKpn-35963cz, and pEsco-36073cz. Plasmid pKpn-35963cz that was an IncFIB(K) molecule contained an acquired sequence, encoding NDM-1 metallo-β-lactamase (MβL), which exhibited high similarity to the mosaic region of pS-3002cz from an ST11 K. pneumoniae from Czechia. Finally, pEsco-36073cz was a multireplicon A/C₂+R NDM-1-encoding plasmid. Similar to other type 1 A/C₂ plasmids, the bla_NDM-1 gene was located within the ARI-A resistance island. These findings underlined that IncX3 plasmids have played a major role in the dissemination of bla_NDM-like genes in Czech hospitals. In combination with further evolvement of NDM-like-encoding MDR plasmids through reshuffling, NDM-like producers pose an important public threat.

Keywords: Enterobacter xiangfangensis; IncX3; NDM; ST182; metallo-β-lactamases.