NDM-5 and OXA-181 Beta-Lactamases, a Significant Threat Continues To Spread in the Americas

Area of Science:

• Microbiology
• Infectious Diseases
• Genomics

Background:

• Carbapenem-resistant Gram-negative bacteria, particularly Klebsiella pneumoniae, present a significant global health challenge due to limited treatment options.
• The emergence and spread of carbapenemase-encoding genes contribute to antimicrobial resistance.
• Sentinel surveillance is crucial for early detection and characterization of resistant strains.

Purpose of the Study:

• To report the sentinel detection and comprehensive characterization of a carbapenem-resistant Klebsiella pneumoniae ST147 isolate.
• To identify and analyze the carbapenemase genes and their genetic environment within the isolate.
• To contribute to the understanding of carbapenem resistance mechanisms in Klebsiella pneumoniae.

Main Methods:

• Whole-genome sequencing and resistome analysis of the carbapenem-resistant Klebsiella pneumoniae isolate.
• Plasmid and chromosomal DNA analysis to determine the location of resistance genes.
• Bioinformatic analysis to identify mobile genetic elements and genetic structures associated with resistance genes.

Main Results:

• Detection of a carbapenem-resistant Klebsiella pneumoniae ST147 isolate from a patient in India.
• Identification of two carbapenemase genes: blaNDM-5 located on a ~90 kb IncFII plasmid and blaOXA-181 chromosomally encoded.
• Genomic analysis revealed multiple copies of the IS26 transposable element and a hotspot region within the IncFII plasmid.

Conclusions:

• The study highlights the presence of a multidrug-resistant Klebsiella pneumoniae ST147 strain carrying both NDM-5 and OXA-181 carbapenemases.
• The genetic context, including plasmid location and IS26 elements, provides insights into the potential dissemination mechanisms of these resistance genes.
• This finding underscores the importance of ongoing surveillance for carbapenem-resistant Gram-negative bacteria and their genetic determinants.