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Int J Antimicrob Agents. 2018 Dec 19. pii: S0924-8579(18)30367-4. doi: 10.1016/j.ijantimicag.2018.12.005. [Epub ahead of print]

Molecular characterization of novel sequence type of carbapenem-resistant NDM-1 producing Klebsiella pneumoniae in NICU of Indian Hospital.

Author information

1
Medical Microbiology and Molecular Biology Lab., Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh - 202 002, India.
2
Pediatrics Department, JN Medical College and Hospital, AMU Aligarh.
3
Medical Microbiology and Molecular Biology Lab., Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh - 202 002, India. Electronic address: asad.k@rediffmail.com.

Abstract

Emergence of multi-drug resistance, especially carbapenem-resistant Klebsiella pneumoniae is a major threat to public health. The aim of this study was to characterize carbapenem-resistant K. pneumoniae (CRKP) isolates from infants admitted to the Neonatal Intensive Care Unit (NICU) to find the clonal outbreak of NDM producers. In this study 17 carbapenem-resistant, K. pneumoniae isolates were analyzed. Antimicrobial susceptibility of the isolates was determined by the disc diffusion and micro-dilution method. Carba NP test and double disk synergy test (DDST) were performed for the detection of carbapenemase and Metallo-β-lactamase producing K. pneumoniae. Antibiotic resistant markers were detected by PCR followed by sequencing. Clonal relatedness of the isolates was checked by multi-locus sequence typing. Conjugation experiments were performed to determine the transferability of the plasmids. All 17 carbapenem-resistant K. pneumoniae isolates were found to carry blaNDM (13 blaNDM-1, 1 blaNDM-4 and 3 blaNDM-5), 7 isolates carried blaOXA-48, 13 isolates have blaCTX-M-15, 7 isolates carried blaCMY-1 and 5 isolates were found to carry blaSHV-1 on conjugative plasmids of different types (IncFIA, IncFIB, IncFIIAs, IncFIC, IncA/C, IncF, IncK, IncX, IncW and IncY). Of six different STs identified, ST3344 was detected as a novel sequence type in two K. pneumoniae isolates. Genetic environment analysis revealed ISAba125 and bleomycin genes flanking to all blaNDM variants. This is the first report of novel ST3344 in two NDM-1 producing K. pneumoniae isolates from neonates admitted in NICU of one of the North Indian Hospitals. This study is leading to understand the genetic features of newly emerged strain type.

KEYWORDS:

Klebsiella pneumoniae; MLST; NDM, Carbapenem-resistant; NICU; OXA-48

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