Emergence and Spread of Carbapenem-Resistant and Aminoglycoside-Panresistant Enterobacter cloacae Complex Isolates Coproducing NDM-Type Metallo-β-Lactamase and 16S rRNA Methylase in Myanmar

mSphere. 2020 Mar 11;5(2):e00054-20. doi: 10.1128/mSphere.00054-20.

Abstract

Surveillance of 10 hospitals and a regional public health laboratory in Myanmar identified 31 isolates of carbapenem-resistant Enterobacter cloacae complex harboring blaNDM-type Of these isolates, 19 were highly resistant to aminoglycosides and harbored one or more genes encoding 16S rRNA methylases, including armA, rmtB, rmtC, and/or rmtE Of the 19 isolates, 16 were Enterobacter xiangfangensis ST200, with armA on the chromosome and a plasmid harboring blaNDM-1 and rmtC, indicating that these isolates were clonally disseminated nationwide in Myanmar.IMPORTANCE The emergence of multidrug-resistant E. cloacae complex has become a public health threat worldwide. E. xiangfangensis is a recently classified species belonging to E. cloacae complex. Here, we report a clonal dissemination of multidrug-resistant E. xiangfangensis ST200 producing two types of New Delhi metallo-β-lactamase (NDM-type MBL), NDM-1 and -4, and three types of 16S rRNA methylases, ArmA, RmtC, and RmtE, in hospitals in Myanmar. The observation of these multidrug-resistant E. xiangfangensis ST200 isolates stresses the urgency to continue molecular epidemiological surveillance of these pathogens in Myanmar and in South Asian countries.

Keywords: 16S rRNA methylase; Enterobacter cloacae complex; NDM-type metallo-β-lactamase.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aminoglycosides / pharmacology*
  • Anti-Bacterial Agents / pharmacology
  • Bacterial Proteins / genetics
  • Carbapenems / pharmacology*
  • Drug Resistance, Multiple, Bacterial*
  • Enterobacter / drug effects
  • Enterobacter / genetics
  • Enterobacter cloacae / drug effects*
  • Enterobacter cloacae / enzymology
  • Enterobacter cloacae / genetics
  • Enterobacteriaceae Infections / epidemiology
  • Enterobacteriaceae Infections / microbiology
  • Humans
  • Methyltransferases / genetics*
  • Microbial Sensitivity Tests
  • Myanmar / epidemiology
  • Phylogeny
  • RNA, Ribosomal, 16S / genetics
  • beta-Lactamases / genetics*

Substances

  • Aminoglycosides
  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Carbapenems
  • RNA, Ribosomal, 16S
  • Methyltransferases
  • rRNA (adenosine-O-2'-)methyltransferase
  • beta-Lactamases
  • beta-lactamase NDM-1

Supplementary concepts

  • Enterobacter hormaechei subsp. xiangfangensis