Molecular Epidemiology of OXA-48 and NDM-1 Producing Enterobacterales Species at a University Hospital in Tehran, Iran, Between 2015 and 2016

• Published in: Frontiers in microbiology 2020-05, Vol.11, p.936-936
• Main Authors: Solgi, Hamid, Nematzadeh, Shoeib, Giske, Christian G., Badmasti, Farzad, Westerlund, Fredrik, Lin, Yii-Lih, Goyal, Gaurav, Nikbin, Vajihe Sadat, Nemati, Amir Hesam, Shahcheraghi, Fereshteh
• Format: Article
• Language: English
• Subjects: carbapenemase-producing Enterobacterales; Medicin och hälsovetenskap; Microbiology; MLST; optical DNA mapping; PFGE; ST147
• ISSN: 1664-302X; 1664-302X
• DOI: 10.3389/fmicb.2020.00936

Carbapenem-resistant Enterobacterales (CRE) is an increasing problem worldwide. Here, we examined the clonal relatedness of 71 non-repetitive CRE isolates collected in a university hospital in Tehran, Iran, between February 2015 and March 2016. Pulsed-field gel electrophoresis (PFGE) and MLST were used for epidemiological analysis. Screening for antibiotic resistance genes, PCR-based replicon typing, conjugation experiments, and optical DNA mapping were also performed. Among all 71 isolates, 47 isolates of Klebsiella pneumoniae (66.2%), eight Escherichia coli (11.2%), five Serratia marcescens (7%), and two Enterobacter cloacae (2.8%) harbored bla NDM–1 and bla OXA–48 genes together or alone. PFGE analysis revealed that most of the OXA-48- and NDM-1-producing K. pneumoniae and all of OXA-48-producing S. marcescens were clonally related, while all eight E. coli and two E . cloacae isolates were clonally unrelated. The predominant clones of carbapenemase-producing K. pneumoniae associated with outbreaks within the hospital were ST147 ( n = 13) and ST893 ( n = 10). Plasmids carrying bla NDM–1 and bla OXA–48 were successfully transferred to an E. coli K12-recipient strain. The bla OXA–48 gene was located on an IncL/M conjugative plasmid, while the bla NDM–1 gene was located on both IncFII ∼86-kb to ∼140-kb and IncA/C conjugative plasmids. Our findings provide novel epidemiologic data on carbapenemase-producing Enterobacterales (CPE) in Iran and highlight the importance of horizontal gene transfer in the dissemination of bla NDM–1 and bla OXA–48 genes. The occurrence and transmission of distinct K. pneumoniae clones call for improved infection control to prevent further spread of these pathogens in Iran.