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Characterization of multiple NDM-1-producing Enterobacteriaceae isolates from the same patient
Nathalie Tijet1, David Richardson2, Gregory MacMullin1
1Public Health Ontario Laboratories, Toronto, Ontario, Canada.
Antimicrobial Agents and Chemotherapy
|April 8, 2015
Summary
Carbapenem-resistant bacteria, including E. coli, were found in a patient returning from India. The blaNDM-1 gene, responsible for resistance, was present on plasmids, suggesting gene transfer between bacteria.
Area of Science:
- Infectious Diseases
- Microbiology
- Genetics
Background:
- A patient presented with an infected sacral ulcer after hospitalization in India.
- The patient was admitted to a community hospital in Ontario, Canada.
Purpose of the Study:
- To identify and characterize carbapenem-resistant bacteria and the NDM-1 gene in clinical isolates.
- To investigate the genetic mechanisms of blaNDM-1 gene dissemination.
Main Methods:
- Bacterial isolates from blood and urine cultures were identified.
- Carbapenem resistance and the presence of the blaNDM-1 gene were confirmed.
- Plasmid analysis was performed for comparative studies.
Main Results:
- Carbapenem-resistant Escherichia coli, Enterobacter cloacae, and Providencia stuartii were isolated.
- All identified resistant strains were positive for the blaNDM-1 gene.
- Plasmid analysis indicated lateral gene transfer and independent gene acquisition.
Conclusions:
- The study identified NDM-1 producing carbapenem-resistant organisms in a Canadian hospital.
- Both plasmid-mediated transfer and independent acquisition contribute to the spread of the blaNDM-1 gene.
- This highlights the potential for international spread of antibiotic resistance genes.
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