NDM carbapenemases have spread worldwide. However little information exists about the impact of NDM-producing Enterobacteriaceae in Spain. By WGS, we sought to elucidate the population structure of blaNDM-like-producing K. pneumoniae and E. coli in Spain and to determine the plasmids encoding blaNDM-like genes. High-resolution single nucleotide polymorphism (SNP) typing, core genome multilocus sequence typing (cgMLST) and plasmid reconstruction (PlasmidID) were performed on 59 blaNDM-like-producing K.pneumoniae and 8 E.coli isolated over an 8-year period in Spain.Five major epidemic clones of NDM-producing K. pneumoniae caused five important nationwide outbreaks: ST437/NDM-7, ST437/NDM-1 ST147/NDM-1, ST11/NDM-1 and ST101/NDM-1; in contrast, spread of NDM-producing E. coli was polyclonal. Three blaNDM types were identified: blaNDM-1, 61.2%; blaNDM-7, 32.8%, and blaNDM-5, 6%. Five K. pneumoniae co-produced other carbapenemases (3 blaOXA-48, 2 blaVIM-1). The average number of acquired resistance genes was higher in K. pneumoniae than in E. coli. The plasmids encoding blaNDM-like belonged to IncFII, IncFIB, IncX3, IncR, IncN and IncA2/C types of which IncF, IncR and IncA2/C were associated with multidrug resistance. Genetic surroundings of blaNDM-like genes showed a highly variable region upstream of ISAba125.In the last years NDM-producing K. pneumoniae and E. coli have emerged in Spain; spread of a few high risk K. pneumoniae clones such as ST437/NDM-7, ST437/NDM-1 ST147/NDM-1, ST11/NDM-1 and ST101/NDM-1 caused several inter-regional outbreaks. In contrast, spread of NDM-producing E. coli was polyclonal. Plasmid types IncFII, IncFIB, IncX3, IncR, IncN and IncA2/C encoded blaNDM, and the same IncX3 plasmid was detected in K. pneumoniae and E.coli.
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