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Abstract

Carriage of CTX-M-type extended-spectrum β-lactamase (ESBL) is rare in . During routine surveillance of an endemic ST-621 at a large hospital, isolate MRSN 100690 carrying was cultured from a patient (P2). This was the first detection of this ESBL in the endemic ST-621 lineage. All 1 488 bacterial isolates collected from the same facility in the 12 months prior to the incidence of 100 690 were screened for the presence of . A set of 183 isolates was identified, in which corresponding patient metadata was evaluated for spatiotemporal overlaps with P2. The resulting three isolates, along with 100 690, were long-read sequenced using the Oxford Nanopore MinION platform to determine a potential donor of . The screen revealed a single isolate, MRSN 895358, which carried an IncA/C2 plasmid harbouring . Notably, the patient harbouring 895358, P1, occupied the same hospital room as P2 9 months prior. Genomic alignment revealed that both isolates shared an identical 80.8 kb region containing the IncA/C2 plasmid replicon and . This region was plasmid bound in 895 358, but chromosomally bound in 100 690 due to Tn-mediated transposition. ESBL was acquired and subsequently integrated into the chromosome of a ST-621 , likely initiated by plasmid transfer from a strain.

Funding
This study was supported by the:
  • Defense Health Program Operation & Maintenance
    • Principal Award Recipient: NotApplicable
  • This information is licensed under the Open Government Licence 3.0. This is an open-access article distributed under the terms of the Creative Commons Attribution License.
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/content/journal/mgen/10.1099/mgen.0.001303
2024-10-16
2026-04-22

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