1887

Abstract

Fifteen isolates harbouring genes were identified from blood and sputum specimens of patients at a tertiary-care facility (Yangon General Hospital, Yangon, Myanmar) in 2018. Two of the isolates belonged to sequence type (ST) 11, an international high-risk clone. Whole-genome sequencing and phylogenetic analyses revealed that these two isolates were clustered together with other ST11 isolates originating from other countries. The isolates harboured the gene on an IncFII-type plasmid that is prevalent among carbapenemase-producing in Yangon but has rarely been found in other ST11 isolates. Our data suggests the regional presence of the ST11 international high-risk clone and its acquisition of an endemic -carrying plasmid.

Funding
This study was supported by the:
  • Japan Agency for Medical Research and Development
    • Principle Award Recipient: ShigeyukiHamada
Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.001348
2021-05-26
2024-04-19
Loading full text...

Full text loading...

References

  1. Temkin E, Adler A, Lerner A, Carmeli Y. Carbapenem-resistant Enterobacteriaceae: biology, epidemiology, and management. Ann N Y Acad Sci 2014; 1323:22–42 [View Article][PubMed]
    [Google Scholar]
  2. van Duin D, Doi Y. The global epidemiology of carbapenemase-producing Enterobacteriaceae . Virulence 2017; 8:460–469 [View Article][PubMed]
    [Google Scholar]
  3. Pitout JDD, Nordmann P, Poirel L. Carbapenemase-producing Klebsiella pneumoniae, a key pathogen set for global nosocomial dominance. Antimicrob Agents Chemother 2015; 59:5873–5884 [View Article][PubMed]
    [Google Scholar]
  4. Damjanova I, Toth A, Paszti J, Hajbel-Vekony G, Jakab M. Expansion and countrywide dissemination of ST11, ST15 and ST147 ciprofloxacin-resistant CTX-M-15-type beta-lactamase-producing Klebsiella pneumoniae epidemic clones in Hungary in 2005 - the new MRSAs. J Antimicrob Chemother 2008; 62:978–985 [View Article]
    [Google Scholar]
  5. KS K, Lee JY, Baek JY, Suh JY, Lee MY. Predominance of an ST11 extended-spectrum beta-lactamase-producing Klebsiella pneumoniae clone causing bacteraemia and urinary tract infections in Korea. J Med Microbiol 2010; 59:822–828 [View Article]
    [Google Scholar]
  6. Baraniak A, Machulska M, Zabicka D, Literacka E, Izdebski R. Towards endemicity: large-scale expansion of the NDM-1-producing Klebsiella pneumoniae ST11 lineage in Poland, 2015-16. J Antimicrob Chemother 2019; 74:3199–3204 [View Article]
    [Google Scholar]
  7. Sugawara Y, Akeda Y, Sakamoto N, Takeuchi D, Motooka D et al. Genetic characterization of blaNDM-harboring plasmids in carbapenem-resistant Escherichia coli from Myanmar. PLoS One 2017; 12:e0184720 [View Article][PubMed]
    [Google Scholar]
  8. Sugawara Y, Akeda Y, Hagiya H, Sakamoto N, Takeuchi D et al. Spreading patterns of NDM-producing Enterobacteriaceae in clinical and environmental settings in Yangon, Myanmar. Antimicrob Agents Chemother 2019; 63: [View Article][PubMed]
    [Google Scholar]
  9. Yamamoto N, Asada R, Kawahara R, Hagiya H, Akeda Y. Prevalence of, and risk factors for, carriage of carbapenem-resistant Enterobacteriaceae among hospitalized patients in Japan. J Hosp Infect 2017; 97:212–217 [View Article]
    [Google Scholar]
  10. Shanmugakani RK, Akeda Y, Yamamoto N, Sakamoto N, Hagiya H. PCR-Dipstick Chromatography for Differential Detection of Carbapenemase Genes Directly in Stool Specimens. Antimicrob Agents Chemother 2017; 61: [View Article][PubMed]
    [Google Scholar]
  11. Yong D, Toleman MA, Giske CG, Cho HS, Sundman K. Characterization of a New Metallo-β-Lactamase Gene, blaNDM-1, and a Novel Erythromycin Esterase Gene Carried on a Unique Genetic Structure in Klebsiella pneumoniae Sequence Type 14 from India. Antimicrob Agents Chemother 2009; 53:5046–5054 [View Article][PubMed]
    [Google Scholar]
  12. Politi L, Gartzonika K, Spanakis N, Zarkotou O, Poulou A. Emergence of NDM-1-producing Klebsiella pneumoniae in Greece: evidence of a widespread clonal outbreak. J Antimicrob Chemother 2019; 74:2197–2202 [View Article]
    [Google Scholar]
  13. Zankari E, Hasman H, Cosentino S, Vestergaard M, Rasmussen S. Identification of acquired antimicrobial resistance genes. J Antimicrob Chemother 2012; 67:2640–2644 [View Article][PubMed]
    [Google Scholar]
  14. Larsen MV, Cosentino S, Rasmussen S, Friis C, Hasman H. Multilocus Sequence Typing of Total-Genome-Sequenced Bacteria. J Clin Microbiol 2012; 50:1355–1361 [View Article][PubMed]
    [Google Scholar]
  15. Sugawara Y, Hagiya H, Akeda Y, Aye MM, Myo Win HP. Dissemination of carbapenemase-producing Enterobacteriaceae harbouring bla(NDM) or bla(IMI) in local market foods of Yangon, Myanmar. Sci Rep 2019; 9: [View Article]
    [Google Scholar]
  16. Aung MS, Win NC, San NI, Hlaing MS, Myint YY. Prevalence of extended-spectrum beta-lactamase/carbapenemase genes and quinolone-resistance determinants in Klebsiella pneumoniae clinical isolates from respiratory infections in Myanmar. Microb Drug Resist 2021; 27:36–43 [View Article][PubMed]
    [Google Scholar]
  17. Kolmogorov M, Yuan J, Lin Y, Pevzner PA. Assembly of long, error-prone reads using repeat graphs. Nat Biotechnol 2019; 37:540–546 [View Article][PubMed]
    [Google Scholar]
  18. Walker BJ, Abeel T, Shea T, Priest M, Abouelliel A. Pilon: an integrated tool for comprehensive microbial variant detection and genome assembly improvement. PLoS One 2014; 9:11 [View Article][PubMed]
    [Google Scholar]
  19. Carattoli A, Zankari E, Garcia-Fernandez A, Larsen MV, Lund O. In silico detection and typing of plasmids using plasmidfinder and plasmid multilocus sequence typiSilico Detection and Typing of Plasmids using PlasmidFinder and Plasmid Multilocus Sequence Typing. Antimicrob Agents Chemother 2014; 58:3895–3903 [View Article]
    [Google Scholar]
  20. Wattam AR, Davis JJ, Assaf R, Boisvert S, Brettin T. Improvements to PATRIC, the all-bacterial Bioinformatics Database and Analysis Resource Center. Nucleic Acids Res 2017; 45:D535–D542 [View Article][PubMed]
    [Google Scholar]
  21. Ondov BD, Treangen TJ, Melsted P, Mallonee AB, Bergman NH. Mash: fast genome and metagenome distance estimation using MinHash. Genome Biol 2016; 17:132 [View Article][PubMed]
    [Google Scholar]
  22. Dong N, Zhang R, Liu LZ, RC L, Lin DC. Genome analysis of clinical multilocus sequence Type 11 Klebsiella pneumoniae from China. Microb Genom 2018; 4: [View Article]
    [Google Scholar]
  23. Zhou K, Xiao TT, David S, Wang Q, Zhou YZ. Novel subclone of carbapenem-resistant Klebsiella pneumoniae sequence type 11 with enhanced virulence and transmissibility, China. Emerg Infect Dis 2020; 26:289–297 [View Article][PubMed]
    [Google Scholar]
  24. Darling AE, Mau B, Perna NT. ProgressiveMauve: multiple genome alignment with gene gain. PLoS One 2010; 5:e11147 [View Article][PubMed]
    [Google Scholar]
  25. Croucher NJ, Page AJ, Connor TR, Delaney AJ, Keane JA. Rapid phylogenetic analysis of large samples of recombinant bacterial whole genome sequences using Gubbins. Nucleic Acids Res 2015; 43:e15 [View Article][PubMed]
    [Google Scholar]
  26. Page AJ, Taylor B, Delaney AJ, Soares J, Seemann T. SNP-sites: rapid efficient extraction of SNPs from multi-FASTA alignments. Microb Genom 2016; 2:e000056 [View Article][PubMed]
    [Google Scholar]
  27. Letunic I, Bork P. Interactive tree of life (iTOL) v3: an online tool for the display and annotation of phylogenetic and other trees. Nucleic Acids Res 2016; 44:W245W242 [View Article][PubMed]
    [Google Scholar]
  28. Zhang RM, JY L, Wang Y, Shen JZ, Shen ZQ. Presence of NDM in non-E. coli Enterobacteriaceae in the poultry production environment. J Antimicrob Chemother 2019; 74:2209–2213 [View Article]
    [Google Scholar]
  29. Shin J, Baek JY, Cho SY, Huh HJ, Lee NY. bla(NDM-5)-Bearing IncFII-Type Plasmids of Klebsiella pneumoniae Sequence Type 147 Transmitted by Cross-Border Transfer of a Patient. Antimicrob Agents Chemother 2016; 60:1932–1934 [View Article][PubMed]
    [Google Scholar]
  30. Sonnevend A, Ghazawi A, Hashmey R, Haidermota A, Girgis S. Multihospital occurrence of pan-resistant Klebsiella pneumoniae sequence type 147 with an ISEcp1-Directed bla(OXA-181) insertion in the mgrB gene in the United Arab Emirates. Antimicrob Agents Chemother 2017; 61: [View Article][PubMed]
    [Google Scholar]
  31. Takeuchi D, Akeda Y, Yoshida H, Hagiya H, Yamamoto N. Genomic reorganization by IS26 in a bla(NDM-5)-bearing FII plasmid of Klebsiella pneumoniae isolated from a patient in Japan. J Med Microbiol 2018; 67:1221–1224 [View Article][PubMed]
    [Google Scholar]
  32. Sherchan JB, Tada T, Shrestha S, Uchida H, Hishinuma T. Emergence of clinical isolates of highly carbapenem-resistant Klebsiella pneumoniae co-harboring bla(NDM-5) and bla(OXA-181) or-232 in Nepal. Int J Infect Dis 2020; 92:247–252 [View Article][PubMed]
    [Google Scholar]
  33. Hornsey M, Phee L, Wareham DW. A novel variant, NDM-5, of the New Delhi metallo-beta-lactamase in a multidrug-resistant Escherichia coli ST648 isolate recovered from a patient in the United Kingdom. Antimicrob Agents Chemother 2011; 55:5952–5954 [View Article][PubMed]
    [Google Scholar]
  34. Sullivan MJ, Petty NK, Beatson SA. Easyfig: a genome comparison visualizer. Bioinformatics 2011; 27:1009–1010 [View Article][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.001348
Loading
/content/journal/jmm/10.1099/jmm.0.001348
Loading

Data & Media loading...

Supplements

Supplementary material 1

PDF
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error