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Research article2022Peer reviewedOpen access

High diversity of bla(NDM-1)-encoding plasmids in Klebsiella pneumoniae isolated from neonates in a Vietnamese hospital

Sriram, K. K.; Ekedahl, Elina; Ngoc Thi Bich Hoang; Sewunet, Tsegaye; Berglund, Bjorn; Lundberg, Ludwig; Nematzadeh, Shoeib; Nilsson, Maud; Nilsson, Lennart E.; Le, Ngai Kien; Dien Minh Tran; Hanberger, Hakan; Olson, Linus; Larsson, Mattias; Giske, Christian G.; Westerlund, Fredrik

Abstract

Objectives: The carbapenemase-encoding gene bla(NDM-1) has been reported in Vietnam during the last 10 years, and bla(NDM)-producing Enterobacteriaceae are now silently and rapidly spreading. A key factor behind dissemination of bla NDM-1 is plasmids, mobile genetic elements that commonly carry antibiotic resistance genes and spread via conjugation. The diversity of bla(NDM-1)-encoding plasmids from neonates at a large Vietnamese hospital was characterized in this study.Methods: 18 fecal Klebsiella pneumoniae and Klebsiella quasipneumoniae isolates collected from 16 neonates at a large pediatric hospital in Vietnam were studied using optical DNA mapping (ODM) and next-generation sequencing (NGS). Plasmids carrying the bla(NDM-1) gene were identified by combining ODM with Cas9 restriction. The plasmids in the isolates were compared to investigate whether the same plasmid was present in different patients.Results: Although the same plasmid was found in some isolates, ODM confirmed that there were at least 10 different plasmids encoding bla(NDM-1) among the 18 isolates, thus indicating wide plasmid diversity. The ODM results concur with the NGS data. Interestingly, some isolates had two distinct plasmids encoding bla(NDM-1) that could be readily identified with ODM. The coexistence of different plasmids carrying the same bla(NDM-)1 gene in a single isolate has rarely been reported, probably because of limitations in plasmid characterization techniques.Conclusions: The plasmids encoding the bla(NDM-1) gene in this study cohort were diverse and may represent a similar picture in Vietnamese society. The study highlights important aspects of the usefulness of ODM for plasmid analysis. (c) 2021 The Author(s). Published by Elsevier Ltd.

Keywords

Plasmids; Optical DNA mapping; Carbapenem; bla(NDM-1)

Published in

International Journal of Antimicrobial Agents
2022, Volume: 59, number: 2, article number: 106496

    Associated SLU-program

    AMR: Bacteria

    Sustainable Development Goals

    SDG3 Good health and well-being

    UKÄ Subject classification

    Public Health, Global Health, Social Medicine and Epidemiology
    Cell and Molecular Biology

    Publication identifier

    DOI: https://doi.org/10.1016/j.ijantimicag.2021.106496

    Permanent link to this page (URI)

    https://res.slu.se/id/publ/115791