Characterization of NDM-7 Carbapenemase-Producing Escherichia coli Isolates in the Arabian Peninsula

• DOI: 10.1089/mdr.2016.0216
• Publication Date: 2017-02-03T15:23:47Z
• Authors: Tibor Pál; Akela Ghazawi; Dania Darwish; Laura Villa; Alessandra Carattoli; Rayhan Hashmey; Zulfa Aldeesi; Wafaa Jamal; Vincent Rotimi; Amina Al-Jardani; Seif S. Al-Abri; Ágnes Sonnevend
• Keywords: 0301 basic medicine; Oman; Saudi Arabia; Gene Expression; United Arab Emirates; Minocycline; Microbial Sensitivity Tests; Tigecycline; 03 medical and health sciences; Fosfomycin; Drug Resistance, Multiple, Bacterial; Escherichia coli; Humans; Escherichia coli Infections; Phylogeny; Colistin; adenosine triphosphatase; amikacin; aztreonam; benzalkonium; ceftazidime; ceftriaxone; cephalosporinase; chloramphenicol; chlorhexidine; ciprofloxacin; colistin; DNA topoisomerase; ertapenem; fosfomycin; gentamicin; imipenem; kanamycin; meropenem; metallo beta lactamase; piperacillin plus tazobactam; streptomycin; tetracycline; tigecycline; antiinfective agent; beta lactamase; carbapenem derivative; colistin; fosfomycin; minocycline, adult; aged; antibiotic resistance; antibiotic sensitivity; antibiotic therapy; Article; bacterial virulence; bacterium identification; bacterium isolate; Canada; carbapenemase producing Enterobacteriaceae; carbapenemase producing Escherichia coli; case report; clinical article; Escherichia coli; female; genetic resistance; human; Kuwait; male; middle aged; molecular phylogeny; multidrug resistance; nucleotide sequence; Oman; plasmid; priority journal; Saudi Arabia; sequence analysis; United Arab Emirates; young adult; analogs and derivatives; cell clone; chemistry; classification; drug effect; Escherichia coli; Escherichia coli infection; gene expression; genetics; isolation and purification; metabolism; microbial sensitivity test; microbiology; multilocus sequence typing; phylogeny; transmission, Anti-Bacterial Agents; beta-Lactamases; Carbapenems; Clone Cells; Colistin; Drug Resistance, Multiple, Bacterial; Escherichia coli; Escherichia coli Infections; Fosfomycin; Gene Expression; Humans; Kuwait; Microbial Sensitivity Tests; Minocycline; Multilocus Sequence Typing; Oman; Phylogeny; Plasmids; Saudi Arabia; United Arab Emirates; Anti-Bacterial Agents; Clone Cells; 3. Good health; Carbapenems; Kuwait; Multilocus Sequence Typing; Plasmids

The purpose of this study was to characterize the New Delhi metallo-beta lactamase (NDM)-7-producing Enterobacteriaceae isolated in the Arabian Peninsula.Enterobacteriaceae identified to carry blaNDM-7 in a collection of 157 NDM-producing isolates from Kuwait, Oman, Saudi Arabia, and the United Arab Emirates (UAE) were investigated for their antibiotic and disinfectant susceptibility, and resistance gene content. The virulence profile, phylogenetic and sequence types of the isolates were also determined. The plasmids carrying the blaNDM-7 were transferred, and their complete nucleotide sequence was determined.Four NDM-7-producing Escherichia coli isolated in Kuwait, Oman, and the UAE, respectively, were identified. They were clonally unrelated, carried a few virulence determinants only, and belonged to clonal complexes CC10 and CC23, or ST448. They were all multi-drug resistant but remained susceptible to fosfomycin, tigecycline, and colistin. In all isolates, blaNDM-7 was located on IncX3 type plasmids of a variable size, not harboring any further resistance genes. The plasmids exhibited a high degree of similarity to each other and to pKpN01-NDM7 from Canada, with various size deletions and insertions.Our findings show that IncX3 type plasmids play an important role in the spread of the currently rare NDM-7 variant in the Arabian Peninsula. This association of blaNDM-7 with the IncX3-type plasmid is particularly worrisome, as this type of plasmid was proved to spread other carbapenemases in various species of Enterobacteriaceae worldwide at a high efficiency.