Background
Methods
Bacterial strains
Isolates | Date of hospitalization | Date of isolation | Patient Sex | Patient Age (years) | Clinical Sample | Hospital Ward | Clinical Diagnosis | Antimicrobial Therapy | Outcome |
---|---|---|---|---|---|---|---|---|---|
EC135 | 2016/5/27 | 2016/6/20 | Male | 85 | Sputum | ICU | Acute renal failure | CPS, LEV | Death |
KP387 | 2017/6/7 | 2017/6/26 | Male | 40 | blood | Hematology | Myelodysplastic syndromes | TGC, LEV, AMK | Alive |
EC126 | 2016/7/29 | 2016/8/10 | Female | 76 | urine | Surgery | Uracratia | CPS, TGC | Alive |
EC734 | 2016/7/27 | 2016/9/9 | Female | 61 | pus | ICU | Kidney neoplasms | CPS, IMP, LEV, TGC | Death |
EC463 | 2016/10/7 | 2016/10/24 | Male | 16 | blood | Hematology | Acute lymphoblastic leukemia | AMK, IMP, TZP | Alive |
EC144 | 2016/10/24 | 2016/11/3 | Female | 50 | ascites | Surgery | Gastric cancer | CPS, AMK | Alive |
EC122 | 2017/5/5 | 2017/5/23 | Male | 69 | urine | ICU | Aspiration pneumonia | TZP, CPS, LEV | Alive |
EC611 | 2017/6/12 | 2017/7/5 | Male | 72 | ascites | Surgery | Colonic neoplasms | TZP, CPS, IMP | Alive |
EC418 | 2017/7/11 | 2017/7/22 | Female | 27 | feces | Hematology | Acute myelogenous leukemia | IMP, MEM, LEV | Alive |
CF418 | 2017/7/11 | 2017/7/22 | Female | 27 | feces | Hematology | Acute myelogenous leukemia | IMP, MEM, LEV | Alive |
EC310 | 2017/6/20 | 2017/7/29 | Female | 55 | blood | Infectious Disease | Biliary tract infection | CPS, IMP, LEV, ATM, AMK, TGC | Alive |
Antimicrobial susceptibility testing
Bacterial genotyping
Southern blot analysis and conjugation experiments
Plasmids analysis
Nucleotide sequence accession number
Results and discussion
Isolate characteristics and antimicrobial susceptibility testing
Genetic relatedness
Location of the blaNDM-5 gene
Isolates | MICs (mg/L) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
FEP | IPM | NIT | CAZ | AMK | CIP | ATM | TGC | CPS2/1 | MNO | COL | |
EC126 | > 128 | 8 | 128 | > 128 | > 128 | 128 | > 128 | 0.5 | > 256 | 8 | 0.5 |
EC135 | 64 | 16 | 64 | > 128 | 128 | 128 | 0.125 | 2 | > 256 | 32 | 0.5 |
KP387 | 64 | 16 | 128 | > 128 | 1 | 2 | 0.25 | 4 | > 256 | 32 | 0.5 |
JH387 | 64 | 16 | 16 | > 128 | 0.5 | 0.5 | 0.25 | 0.5 | > 256 | 4 | 0.5 |
EC463 | > 128 | 64 | 8 | > 128 | 1 | 64 | 32 | 2 | > 256 | 64 | 0.5 |
JH 463 | 128 | 64 | 16 | > 128 | 1 | 0.125 | 0.125 | 0.25 | > 256 | 2 | < 0.25 |
EC734 | 64 | 8 | 8 | > 128 | 1 | 64 | 4 | 0.25 | > 256 | 32 | 0.5 |
JH734 | 64 | 16 | 16 | > 128 | 0.5 | 0.25 | 0.125 | 0.5 | > 256 | 2 | < 0.25 |
EC611 | 32 | 8 | 8 | > 128 | 1 | 0.0625 | 0.0625 | 0.25 | > 256 | 2 | 0.25 |
JH611 | 64 | 8 | 8 | > 128 | 0.5 | 0.0625 | 0.125 | 0.5 | > 256 | 2 | 0.25 |
EC144 | 128 | 32 | 32 | > 128 | > 128 | 64 | 128 | 0.25 | > 256 | 32 | 0.5 |
JH144 | 128 | 16 | 32 | > 128 | 0.5 | 0.5 | 0.125 | 0.5 | > 256 | 2 | < 0.25 |
EC122 | > 128 | 32 | 64 | > 128 | > 128 | 64 | > 256 | 8 | > 256 | 128 | 0.5 |
JH122 | 128 | 16 | 16 | > 128 | 0.5 | 0.5 | 0.125 | 0.5 | > 256 | 2 | < 0.25 |
EC418 | 32 | 8 | 32 | > 128 | 1 | 0.25 | 0.125 | 1 | > 256 | 48 | 0.5 |
JH418 | 32 | 8 | 16 | > 128 | 0.5 | 0.25 | 0.125 | 0.5 | > 256 | 2 | < 0.25 |
CF418 | 32 | 32 | 8 | > 128 | 1 | 0.25 | 0.l25 | 0.5 | > 256 | 4 | 0.5 |
JHF418 | 16 | 8 | 8 | > 128 | 1 | 0.25 | 0.125 | 0.5 | > 256 | 2 | < 0.25 |
EC310 | > 128 | 128 | 8 | > 128 | 1 | 8 | 0.19 | 0.5 | > 256 | 2 | 0.5 |
JHE310 | > 128 | 64 | 8 | > 128 | 0.5 | 0.5 | 0.125 | 0.5 | > 256 | 1 | < 0.25 |
EC600 | 0.125 | 0.5 | 8 | 0.25 | 0.5 | 0.125 | 0.25 | 0.125 | 0.5 | 1 | < 0.25 |
ATCC25922a | 0.125 | 0.5 | < 8 | 0.125 | 0.5 | 0.125 | 0.125 | 0.125 | 0.25 | 0.25 | < 0.25 |
Plasmid sequence analysis of blaNDM-5
Inc. group | Transferabilitya | Size (kb) | Host strain | MLST | Sample | Country | Reference |
---|---|---|---|---|---|---|---|
IncX3 | T | 46b |
K. pneumoniae
| – | Human Blood | India | [8] |
– | 46b |
E. coli
| ST1284 | Human Groin | Denmark | [24] | |
– | 46b |
E. coli
| ST648 | Human Urine | India | [5] | |
C | 46b |
E. coli
| ST167 | Human Rectum | China | [6] | |
C | 46b |
E. coli
| ST167 | Human Urine | China | [30] | |
C | 46b |
E. coli
| ST167 | Human Blood | China | [30] | |
C | 46b |
E. coli
| ST2608 | Human Swab | China | [30] | |
C | 46b |
E. coli
| ST5131 | Human Vaginal secretions | China | [30] | |
T | 46b |
E. coli
| ST167 | Human sputum | China | [3] | |
T | 46b |
E. coli
| ST167 | Human Urine | China | [3] | |
T | 46b |
E. coli
| ST167 | Human Blood | China | [21] | |
T | 46b |
E. coli
| ST167 | Human Blood | China | [15] | |
T | 46b |
E. coli
| ST206 | Human stool | China | [31] | |
C | 46b |
K. michiganensis
| – | Human stool | China | [32] | |
C | 46b |
E. coli
| ST446 | Cows fecal | China | [11] | |
C | 46b |
E. coli
| ST2 | Cows fecal | China | [11] | |
C | 46b |
E. coli
| ST3 | Cows fecal | China | [11] | |
C | 46b |
E. coli
| ST354 | Human ascites | China | this study | |
C | 46b |
E. coli
| ST746 | Human feces | China | this study | |
C | 46b |
E. coli
| ST6395 | Human blood | China | this study | |
C | 46b |
E. coli
| ST6335 | Human pus | China | this study | |
C | 46b |
E. coli
| ST12 | Human ascites | China | this study | |
– | 46b |
E. coli
| ST410 | Human sputum | China | this study | |
C | 46b |
E. coli
| ST361 | Human blood | China | this study | |
C | 46b |
E. coli
| ST167 | Human urine | China | this study | |
– | 46b |
E. coli
| ST617 | Human Urine | China | this study | |
C | 46b |
K. pneumoniae
| Human blood | China | this study | ||
C | 46b |
C. freundii
| – | Human feces | China | this study | |
IncF | – | > 100 |
E. coli
| ST648 | Human throat | UK | [2] |
T | > 100 |
E. coli
| – | Human pus | India | [33] | |
T | > 100 |
E. coli
| – | Human pus | India | [33] | |
IncFII | T | 84.5 |
Salmonella enterica serovar Typhimurium
| ST34 | Human fecal | China | [34] |
C | 110 |
E. coli
| ST418 | Human stool | Poland | [35] | |
C | 90 |
E. coli
| ST418 | Human urine | Spain | [36] | |
IncN | C | 110 |
E. coli
| ST540 | Human feces | Japan | [37] |
Untypeable | C | 48 |
K. pneumoniae
| ST231 | Human urine | Singapore | [38] |