AUTHOR=Marchetti Vittoria Mattioni , Bitar Ibrahim , Mercato Alessandra , Nucleo Elisabetta , Bonomini Annalisa , Pedroni Palmino , Hrabak Jaroslav , Migliavacca Roberta 

TITLE=Complete Nucleotide Sequence of Plasmids of Two Escherichia coli Strains Carrying blaNDM–5 and blaNDM–5 and blaOXA–181 From the Same Patient

JOURNAL=Frontiers in Microbiology

VOLUME=10

YEAR=2020

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2019.03095

DOI=10.3389/fmicb.2019.03095

ISSN=1664-302X

ABSTRACT=<p>Aim of this study was to genetically characterize two carbapenemase-producing <italic>Escherichia coli</italic> strains obtained from a pediatric patient affected by diarrhea, expressing OXA-181 and/or NDM-5 type enzymes. The above microorganisms were collected in the same Desenzano hospital (Northern Italy) where the <italic>bla</italic><sub>NDM–</sub><sub>5</sub> gene was detected for the first time in Italy 3 years ago. One strain (5P), belonged to sequence type ST405/ST477 (according to Pasture/Oxford schemes) and serotype O102:H6. It was characterized by a 130562 bp multi-replicon plasmid IncFII/IncFIA/IncFIB (pVSI_NDM-5) enclosing two main antibiotic resistance islands: (i) ARI-I, 10030 bp in size, carried genes coding for β-lactam- (<italic>bla</italic><sub>OXA–</sub><sub>1</sub>, <italic>bla</italic><sub>CTX–M–</sub><sub>15</sub>), fluoroquinolone/aminoglycoside- (<italic>aac(6′)-lb-cr</italic>) and phenicol- resistance (<italic>catB3</italic>), (ii) ARI-II, 15326 bp in size, carried genes coding for sulfonamide- (<italic>sul1</italic>), β-lactam- (<italic>bla</italic><sub>NDM–</sub><sub>5</sub>, <italic>bla</italic><sub>TEM–</sub><sub>1</sub><sub>B</sub>), phenicol- (<italic>catB3</italic>), trimethoprim- (<italic>dfrA17</italic>), antiseptic- (<italic>qacE</italic>Δ<italic>1</italic>), and aminoglycoside- (<italic>aadA5</italic>, <italic>rmtB</italic>) resistance. The other isolate (5M), belonged to sequence type ST2659/ST759 and serotype O50/02:H18, and carried four plasmids: a 153866 bp multi-replicon IncFII/IncFIA/IncFIB (pISV_IncFII_NDM-5), an 89866 bp IncI1 plasmid, a 51480 bp IncX3 plasmid (pISV_IncX3_OXA181), and a 41143 bp IncI plasmid (pISV_IncI_CMY-42). pISV_IncFII_NDM-5 carried two main antibiotic resistance islands: (i) ARI-III, 12220 bp in size, carried genes coding for β-lactam- (<italic>bla</italic><sub>OXA–</sub><sub>1</sub>), fluoroquinolone/aminoglycoside- (<italic>aac(6′)-lb-cr</italic>), tetracycline- (<italic>tet(B)</italic>) and phenicol- resistance (<italic>catB3</italic>, <italic>catA1</italic>), and ii) ARI-IV, 26527 bp in size, carried determinants coding for macrolide- (<italic>erm(B)</italic>, <italic>mph(A)</italic>), sulfonamide- (<italic>sul1</italic>), beta-lactam- (<italic>bla</italic><sub>NDM–</sub><sub>5</sub>, <italic>bla</italic><sub>TEM–</sub><sub>1</sub><sub>B</sub>), trimethoprim- (<italic>dfrA14</italic>, <italic>dfrA12</italic>), antiseptic- (<italic>qacE</italic>Δ<italic>1</italic>), and aminoglycoside- resistance (<italic>aadA5</italic>). pISV_IncI_CMY-42 harbored the <italic>bla</italic><sub>CMY–</sub><sub>42</sub> gene coding for beta-lactam resistance, pISV_IncX3_OXA181 harbored genes encoding fluoroquinolone- (<italic>qnrS1</italic>) and beta-lactams- resistance (<italic>bla</italic><sub>OXA–</sub><sub>181</sub>). In conclusion, the detection of two different NDM-5 <italic>E. coli</italic> strains from a pediatric patient with a history of travel to the Far East countries strongly highlight an increasing trend and risk of importation from such areas.</p>