Emergence and dissemination of multidrug-resistant Escherichia coli ST8346 coharboring blaNDM-5 and blaOXA-181 in Southern Taiwan, 2017–2021

Chia Hung Tsai; Nan Yao Lee; Chien Ming Chao; Chi Chung Chen; Chih Cheng Lai; Chung Han Ho; Yu Chin Chen; Po Yu Chen; Hung Jen Tang; Hung Jui Chen; Bo An Su; Hsin Yu Lai; Julie Chi Chow; Tu Hsuan Chang

doi:10.1016/j.jiph.2023.08.007

Emergence and dissemination of multidrug-resistant Escherichia coli ST8346 coharboring bla_NDM-5 and bla_OXA-181 in Southern Taiwan, 2017–2021

Chia Hung Tsai, Nan Yao Lee, Chien Ming Chao, Chi Chung Chen, Chih Cheng Lai, Chung Han Ho, Yu Chin Chen, Po Yu Chen, Hung Jen Tang, Hung Jui Chen, Bo An Su, Hsin Yu Lai, Julie Chi Chow, Tu Hsuan Chang

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Background: Enterobacterales carrying bla_NDM represent an emerging challenge in treating infectious diseases. In this study, we aimed to investigate the characteristics of bla_NDM-producing Enterobacterales from three hospitals in southern Taiwan. Methods: Enterobacterales strains that were nonsusceptible to more than one carbapenem (ertapenem, meropenem, imipenem, or doripenem) were collected from hospitalized patients. Molecular typing for New Delhi metallo-β-lactamase (NDM) and antibiotic susceptibility tests were performed, followed by multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), and plasmid analysis by PCR-based replicon typing. Results: A total of 1311 carbapenem-nonsusceptible Enterobacterales were isolated from 2017 to 2021. bla_NDM-encoding genes were detected in 108 isolates, with 53 (49.1%) harboring bla_NDM-1 and 55 (50.9%) harboring bla_NDM-5. The rate of bla_NDM-1 detection among isolates decreased to 2% in 2021. However, the rate of E. coli harboring bla_NDM-5 increased from 1% to 12% of total isolates during the study period. Of 47 NDM-5-positive E. coli isolates, 44 (93.6%) were ST8346 with high genetic relatedness. E. coli ST8346 isolates showed high-level resistance to both carbapenems and aminoglycosides. Most (38 out of 47, 80.9%) bla_NDM-5-harboring E. coli isolates co-harbored bla_OXA-181. We analyzed the regions harboring bla_NDM-5 in E. coli ST8346 via PCR amplification. bla_NDM-5 and bla_OXA-181 were located on two separate plasmids, IncF and IncX3, respectively. Conclusion: The dissemination of E. coli ST8346 caused an increase in bla_NDM-5 and bla_OXA-181 co-harboring Enterobacterales in southern Taiwan, which show high-level resistance to both carbapenems and aminoglycosides. We identified a distinct IncF plasmid encoding bla_NDM-5 that has the potential for rapid spread and needs further surveillance.

Original language	English
Pages (from-to)	1675-1681
Number of pages	7
Journal	Journal of Infection and Public Health
Volume	16
Issue number	10
DOIs	https://doi.org/10.1016/j.jiph.2023.08.007
Publication status	Published - 2023 Oct

All Science Journal Classification (ASJC) codes

Public Health, Environmental and Occupational Health
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jiph.2023.08.007

Cite this

Tsai, C. H., Lee, N. Y., Chao, C. M., Chen, C. C., Lai, C. C., Ho, C. H., Chen, Y. C., Chen, P. Y., Tang, H. J., Chen, H. J., Su, B. A., Lai, H. Y., Chow, J. C., & Chang, T. H. (2023). Emergence and dissemination of multidrug-resistant Escherichia coli ST8346 coharboring bla_NDM-5 and bla_OXA-181 in Southern Taiwan, 2017–2021. Journal of Infection and Public Health, 16(10), 1675-1681. https://doi.org/10.1016/j.jiph.2023.08.007

@article{f51d0600b6ac4ba38212342cef1e5bb8,

title = "Emergence and dissemination of multidrug-resistant Escherichia coli ST8346 coharboring blaNDM-5 and blaOXA-181 in Southern Taiwan, 2017–2021",

abstract = "Background: Enterobacterales carrying blaNDM represent an emerging challenge in treating infectious diseases. In this study, we aimed to investigate the characteristics of blaNDM-producing Enterobacterales from three hospitals in southern Taiwan. Methods: Enterobacterales strains that were nonsusceptible to more than one carbapenem (ertapenem, meropenem, imipenem, or doripenem) were collected from hospitalized patients. Molecular typing for New Delhi metallo-β-lactamase (NDM) and antibiotic susceptibility tests were performed, followed by multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), and plasmid analysis by PCR-based replicon typing. Results: A total of 1311 carbapenem-nonsusceptible Enterobacterales were isolated from 2017 to 2021. blaNDM-encoding genes were detected in 108 isolates, with 53 (49.1%) harboring blaNDM-1 and 55 (50.9%) harboring blaNDM-5. The rate of blaNDM-1 detection among isolates decreased to 2% in 2021. However, the rate of E. coli harboring blaNDM-5 increased from 1% to 12% of total isolates during the study period. Of 47 NDM-5-positive E. coli isolates, 44 (93.6%) were ST8346 with high genetic relatedness. E. coli ST8346 isolates showed high-level resistance to both carbapenems and aminoglycosides. Most (38 out of 47, 80.9%) blaNDM-5-harboring E. coli isolates co-harbored blaOXA-181. We analyzed the regions harboring blaNDM-5 in E. coli ST8346 via PCR amplification. blaNDM-5 and blaOXA-181 were located on two separate plasmids, IncF and IncX3, respectively. Conclusion: The dissemination of E. coli ST8346 caused an increase in blaNDM-5 and blaOXA-181 co-harboring Enterobacterales in southern Taiwan, which show high-level resistance to both carbapenems and aminoglycosides. We identified a distinct IncF plasmid encoding blaNDM-5 that has the potential for rapid spread and needs further surveillance.",

author = "Tsai, {Chia Hung} and Lee, {Nan Yao} and Chao, {Chien Ming} and Chen, {Chi Chung} and Lai, {Chih Cheng} and Ho, {Chung Han} and Chen, {Yu Chin} and Chen, {Po Yu} and Tang, {Hung Jen} and Chen, {Hung Jui} and Su, {Bo An} and Lai, {Hsin Yu} and Chow, {Julie Chi} and Chang, {Tu Hsuan}",

note = "Publisher Copyright: {\textcopyright} 2023 The Author(s)",

year = "2023",

month = oct,

doi = "10.1016/j.jiph.2023.08.007",

language = "English",

volume = "16",

pages = "1675--1681",

journal = "Journal of Infection and Public Health",

issn = "1876-0341",

publisher = "Elsevier BV",

number = "10",

}

Tsai, CH, Lee, NY, Chao, CM, Chen, CC, Lai, CC, Ho, CH, Chen, YC, Chen, PY, Tang, HJ, Chen, HJ, Su, BA, Lai, HY, Chow, JC & Chang, TH 2023, 'Emergence and dissemination of multidrug-resistant Escherichia coli ST8346 coharboring bla_NDM-5 and bla_OXA-181 in Southern Taiwan, 2017–2021', Journal of Infection and Public Health, vol. 16, no. 10, pp. 1675-1681. https://doi.org/10.1016/j.jiph.2023.08.007

TY - JOUR

T1 - Emergence and dissemination of multidrug-resistant Escherichia coli ST8346 coharboring blaNDM-5 and blaOXA-181 in Southern Taiwan, 2017–2021

AU - Tsai, Chia Hung

AU - Lee, Nan Yao

AU - Chao, Chien Ming

AU - Chen, Chi Chung

AU - Lai, Chih Cheng

AU - Ho, Chung Han

AU - Chen, Yu Chin

AU - Chen, Po Yu

AU - Tang, Hung Jen

AU - Chen, Hung Jui

AU - Su, Bo An

AU - Lai, Hsin Yu

AU - Chow, Julie Chi

AU - Chang, Tu Hsuan

PY - 2023/10

Y1 - 2023/10

N2 - Background: Enterobacterales carrying blaNDM represent an emerging challenge in treating infectious diseases. In this study, we aimed to investigate the characteristics of blaNDM-producing Enterobacterales from three hospitals in southern Taiwan. Methods: Enterobacterales strains that were nonsusceptible to more than one carbapenem (ertapenem, meropenem, imipenem, or doripenem) were collected from hospitalized patients. Molecular typing for New Delhi metallo-β-lactamase (NDM) and antibiotic susceptibility tests were performed, followed by multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), and plasmid analysis by PCR-based replicon typing. Results: A total of 1311 carbapenem-nonsusceptible Enterobacterales were isolated from 2017 to 2021. blaNDM-encoding genes were detected in 108 isolates, with 53 (49.1%) harboring blaNDM-1 and 55 (50.9%) harboring blaNDM-5. The rate of blaNDM-1 detection among isolates decreased to 2% in 2021. However, the rate of E. coli harboring blaNDM-5 increased from 1% to 12% of total isolates during the study period. Of 47 NDM-5-positive E. coli isolates, 44 (93.6%) were ST8346 with high genetic relatedness. E. coli ST8346 isolates showed high-level resistance to both carbapenems and aminoglycosides. Most (38 out of 47, 80.9%) blaNDM-5-harboring E. coli isolates co-harbored blaOXA-181. We analyzed the regions harboring blaNDM-5 in E. coli ST8346 via PCR amplification. blaNDM-5 and blaOXA-181 were located on two separate plasmids, IncF and IncX3, respectively. Conclusion: The dissemination of E. coli ST8346 caused an increase in blaNDM-5 and blaOXA-181 co-harboring Enterobacterales in southern Taiwan, which show high-level resistance to both carbapenems and aminoglycosides. We identified a distinct IncF plasmid encoding blaNDM-5 that has the potential for rapid spread and needs further surveillance.

AB - Background: Enterobacterales carrying blaNDM represent an emerging challenge in treating infectious diseases. In this study, we aimed to investigate the characteristics of blaNDM-producing Enterobacterales from three hospitals in southern Taiwan. Methods: Enterobacterales strains that were nonsusceptible to more than one carbapenem (ertapenem, meropenem, imipenem, or doripenem) were collected from hospitalized patients. Molecular typing for New Delhi metallo-β-lactamase (NDM) and antibiotic susceptibility tests were performed, followed by multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), and plasmid analysis by PCR-based replicon typing. Results: A total of 1311 carbapenem-nonsusceptible Enterobacterales were isolated from 2017 to 2021. blaNDM-encoding genes were detected in 108 isolates, with 53 (49.1%) harboring blaNDM-1 and 55 (50.9%) harboring blaNDM-5. The rate of blaNDM-1 detection among isolates decreased to 2% in 2021. However, the rate of E. coli harboring blaNDM-5 increased from 1% to 12% of total isolates during the study period. Of 47 NDM-5-positive E. coli isolates, 44 (93.6%) were ST8346 with high genetic relatedness. E. coli ST8346 isolates showed high-level resistance to both carbapenems and aminoglycosides. Most (38 out of 47, 80.9%) blaNDM-5-harboring E. coli isolates co-harbored blaOXA-181. We analyzed the regions harboring blaNDM-5 in E. coli ST8346 via PCR amplification. blaNDM-5 and blaOXA-181 were located on two separate plasmids, IncF and IncX3, respectively. Conclusion: The dissemination of E. coli ST8346 caused an increase in blaNDM-5 and blaOXA-181 co-harboring Enterobacterales in southern Taiwan, which show high-level resistance to both carbapenems and aminoglycosides. We identified a distinct IncF plasmid encoding blaNDM-5 that has the potential for rapid spread and needs further surveillance.

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U2 - 10.1016/j.jiph.2023.08.007

DO - 10.1016/j.jiph.2023.08.007

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