Dissemination of an international high-risk clone of Escherichia coli ST410 co-producing NDM-5 and OXA-181 carbapenemases in Seoul, Republic of Korea

• Published in: International journal of antimicrobial agents 2021-12, Vol.58 (6), p.106448-106448, Article 106448
• Main Authors: Kim, Jin Seok, Yu, Jin Kyung, Jeon, Su Jin, Park, Sang-Hun, Han, Sunghee, Park, So Hyeon, Kang, Minji, Jang, Jung Im, Park, Jungsun, Shin, Eun-Kyung, Kim, Junyoung, Hong, Chae-Kyu, Lee, Jib-Ho, Hwang, Young Ok, Oh, Young-Hee
• Format: Article
• Language: English
• Subjects: amikacin; Anti-Bacterial Agents - pharmacology; antibiotic resistance; Bacterial Proteins - genetics; beta-lactamase; beta-Lactamases - genetics; Carbapenem-Resistant Enterobacteriaceae - genetics; Carbapenem-Resistant Enterobacteriaceae - growth & development; Carbapenem-Resistant Enterobacteriaceae - isolation & purification; carbapenemase; carbapenems; Carbapenems - metabolism; Carbapenems - pharmacology; cephalosporins; ciprofloxacin; colistin; disease control; Drug Resistance, Multiple, Bacterial - genetics; Electrophoresis, Gel, Pulsed-Field; Escherichia coli; Escherichia coli - drug effects; Escherichia coli - genetics; Escherichia coli - isolation & purification; Escherichia coli Infections - drug therapy; Escherichia coli Infections - epidemiology; Escherichia coli Proteins - genetics; genetic similarity; Genome, Bacterial - genetics; Humans; Microbial Sensitivity Tests; Molecular Epidemiology; Multilocus Sequence Typing; multiple drug resistance; plasmids; polymerase chain reaction; pulsed-field gel electrophoresis; Republic of Korea - epidemiology; South Korea; sulfamethoxazole; tetracycline; tigecycline; trimethoprim; Whole Genome Sequencing
• ISSN: 0924-8579; 1872-7913
• DOI: 10.1016/j.ijantimicag.2021.106448

The rapid increase in carbapenemase-producing Enterobacterales is a global health concern. During 2017-2020, a total of 44 Escherichia coli isolates co-harbouring blaNDM-5 and blaOXA-181 were collected from patients at 17 hospitals in Seoul and characterized based on antimicrobial susceptibility, resistance genes and plasmid replicons detected using polymerase chain reaction (PCR). Clonal relatedness was estimated using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). All isolates had an identical multidrug resistance profile, including resistance to carbapenems, cephalosporins, ciprofloxacin, tetracycline, and trimethoprim/sulfamethoxazole, and susceptibility to amikacin, colistin, and tigecycline. Resistance genes (blaCTX-M-15, blaCMY-2, blaTEM-1B, blaOXA-1, aac(6’)-Ib-cr, and qnrS) and plasmid replicons (IncFIA, IncFIB, and IncX3) was observed in almost all isolates. All isolates belonged to ST410 and were genetically similar (>88% similarity), with some PFGE types shared among isolates from different hospitals. Analysis of the whole genome revealed that the isolates clustered together with other strains of the international high-risk clone ST410 B4/H24RxC from other countries. These findings underline the ongoing spread of the high-risk clone of NDM-5- and OXA-181-producing E. coli ST410 B4/H24RxC among hospitals in Seoul. Continuous monitoring and implementation of infection control measures are crucial to track and prevent further spread of these resistant strains.