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Emergence of an NDM-5-Producing Escherichia coli Sequence Type 410 Clone in Infants in a Children's Hospital in China

Jun Li1, Ting Yu1, Xiao-Yan Tao1

  • 1Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan 410008, People's Republic of China.

Infection and Drug Resistance
|March 19, 2020
PubMed

Insights

This study identified an outbreak of New Delhi metallo-β-lactamase (NDM)-5-producing Escherichia coli in a Chinese children's hospital. The findings highlight the clonal spread of this difficult-to-treat superbug among infants, necessitating urgent monitoring.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Genomics

Background:

  • Carbapenem-resistant Enterobacterales (CRE) infections, including New Delhi metallo-β-lactamase (NDM)-producing strains, are a growing global health concern.
  • While primarily affecting adults, CRE infections are increasingly reported in pediatric populations, posing unique clinical challenges.

Purpose of the Study:

  • To characterize an outbreak of infection caused by NDM-5-producing Escherichia coli in a pediatric hospital setting in China.
  • To investigate the molecular epidemiology and transmission dynamics of NDM-5-producing E. coli in hospitalized infants.

Main Methods:

  • Collection and analysis of 86 carbapenem-resistant Enterobacterales isolates from 85 hospitalized children over a 12-month period.
  • Utilized a combination of phenotypic (antimicrobial susceptibility testing) and molecular techniques (PCR, PFGE, MLST, WGS) for isolate characterization.
  • Investigated clinical data, including hospitalization overlap and travel history, to understand transmission pathways.

Main Results:

  • Identified 9 isolates of NDM-5-producing E. coli, with 5 isolates exhibiting identical PFGE patterns, MLST type (ST410), and plasmid replicon type (IncFII).
  • All 9 isolates demonstrated resistance to multiple antibiotics, including carbapenems, cephalosporins, and levofloxacin, but remained susceptible to trimethoprim/sulfamethoxazole, amikacin, tigecycline, and colistin.
  • Clinical data indicated a potential nosocomial transmission event among infants within a short timeframe, with no travel history reported.

Conclusions:

  • The findings suggest a clonal outbreak of NDM-5-producing E. coli, likely driven by nosocomial transmission within the pediatric hospital.
  • This study represents the first documented outbreak of NDM-5-producing E. coli mediated by IncFII in infants.
  • Urgent and enhanced surveillance is crucial for preventing the further spread of this highly resistant pathogen in vulnerable pediatric populations.
Abstract

Keywords:
EnterobacteralesIncFIIblaNDM-5carbapenem resistance

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