AUTHOR=Zou Hua , Jia Xiaojiong , Liu Hang , Li Shuang , Wu Xianan , Huang Shifeng 

TITLE=Emergence of NDM-5-Producing Escherichia coli in a Teaching Hospital in Chongqing, China: IncF-Type Plasmids May Contribute to the Prevalence of blaNDM–5

JOURNAL=Frontiers in Microbiology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2020.00334

DOI=10.3389/fmicb.2020.00334

ISSN=1664-302X

ABSTRACT=<p>The newly emerging NDM-5 confers increased antibiotic resistance and attracts extensive global attention, but the prevalence, dissemination mechanism, and clinical significance of NDM-5 among clinical <italic>Escherichia coli</italic> (<italic>E. coli</italic>) infections have not been thoroughly characterized to date. In the present study, 109 unique carbapenem-resistant <italic>E. coli</italic> (CR-EC) isolates were collected in Southwest China, from 2013 to 2017, among which 41 (37.61%) CR-EC isolates were identified as NDM-5-producers, with most isolates carrying the IncF-type plasmids. Molecular epidemiological studies revealed ST167 being the most common sequence type (ST). Moreover, we described the first report of a clinical CR-EC isolate co-harboring <italic>bla</italic><sub>KPC–</sub><sub>2</sub> and <italic>bla</italic><sub>NDM–</sub><sub>5</sub>, which showed a higher level of resistance to carbapenems. In addition, <italic>bla</italic><sub>NDM–</sub><sub>5</sub> plasmid transformation and conjugation indicated that <italic>bla</italic><sub>NDM–</sub><sub>5</sub> itself did confer resistance to carbapenems. Complete sequencing of the <italic>bla</italic><sub>NDM–</sub><sub>5</sub>-harboring IncF plasmid revealed highly conserved regions (<italic>ble</italic><sub>MBL</sub>-<italic>trpF</italic>-<italic>tat</italic>) and some transposons around <italic>bla</italic><sub>NDM–</sub><sub>5</sub>. Our findings revealed a new potential threat of NDM-5-postive CR-EC in mainland China and emphasized an urgent need to control their further spread.</p>