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Emergence of NDM-producing Klebsiella pneumoniae and Escherichia coli in Spain: phylogeny, resistome, virulence and plasmids encoding blaNDM-like genes as determined by WGS

2019; Oxford University Press; Volume: 74; Issue: 12 Linguagem: Inglês

10.1093/jac/dkz366

1460-2091

Marı́a Pérez-Vázquez, Pedro J. Sola‐Campoy, Adriana Ortega, Verónica Bautista, Sara Monzón, Guillermo Ruiz‐Carrascoso, Jesús Mingorance, Eva M. González‐Barberá, Concepción Gimeno, Belén Aracil, David Saéz, Noelia Lara, Sara Monzón, Juan José González‐López, José Campos, Robert A. Kingsley, Gordon Dougan, Jesús Oteo, Cristina Herrera Rodrigo, Esteban Aznar, Luisa García-Picazo, Beatriz Orden Martínez, Emilia Cercenado Mansilla, Patricia Álvarez-García, Julia María Pita Carretero, Irene Rodríguez-Conde, Sonia María Rey Cao, Adelina Gimeno, Mar Olga Pérez Moreno, Ma Luz Cordón Rodríguez, Teresa Alarcón Cavero, Yolanda Blasco Gil, M.A. Remacha Esteras, José Luis Barrios Andrés, Glòria Trujillo, J.L. Hernández Almaraz, José Luís del Pozo, Carmen Martín Salas, Fernando Buñuel Adán, Frederic Gómez, Paloma Cascales, José Cobos Dorado, Concepción Balado Suarez,

Pharmaceutical and Antibiotic Environmental Impacts

Abstract Objectives NDM carbapenemases have spread worldwide. However, little information exists about the impact of NDM-producing Enterobacteriaceae in Spain. By WGS, we sought to elucidate the population structure of NDM-like-producing Klebsiella pneumoniae and Escherichia coli in Spain and to determine the plasmids harbouring blaNDM-like genes. Methods High-resolution SNP typing, core-genome MLST and plasmid reconstruction (PlasmidID) were performed on 59 NDM-like-producing K. pneumoniae and 8 NDM-like-producing E. coli isolated over an 8 year period in Spain. Results Five major epidemic clones of NDM-producing K. pneumoniae caused five important nationwide outbreaks: ST437/NDM-7, ST437/NDM-1, ST147/NDM-1, ST11/NDM-1 and ST101/NDM-1; in contrast, the spread of NDM-producing E. coli was polyclonal. Three blaNDM types were identified: blaNDM-1, 61.2%; blaNDM-7, 32.8%; and blaNDM-5, 6%. Five K. pneumoniae isolates co-produced other carbapenemases (three blaOXA-48 and two blaVIM-1). The average number of acquired resistance genes was higher in K. pneumoniae than in E. coli. The plasmids encoding blaNDM-like genes belonged to IncFII, IncFIB, IncX3, IncR, IncN and IncC types, of which IncF, IncR and IncC were associated with MDR. The genetic surroundings of blaNDM-like genes showed a highly variable region upstream of ISAba125. Conclusions In recent years NDM-producing K. pneumoniae and E. coli have emerged in Spain; the spread of a few high-risk K. pneumoniae clones such as ST437/NDM-7, ST437/NDM-1, ST147/NDM-1, ST11/NDM-1 and ST101/NDM-1 have caused several interregional outbreaks. In contrast, the spread of NDM-producing E. coli has been polyclonal. Plasmid types IncFII, IncFIB, IncX3, IncR, IncN and IncC carried blaNDM, and the same IncX3 plasmid was detected in K. pneumoniae and E. coli.