Emergence of clinical isolates of highly carbapenem-resistant Klebsiella pneumoniae co-harboring blaNDM-5 and blaOXA-181 or -232 in Nepal
Jatan Bahadur Sherchan, Tatsuya Tada, Shovita Shrestha, Hiroki Uchida, Tomomi Hishinuma, Shinichiro Morioka, R. Shahi, Sarita Bhandari, Roshna T. Twi, Teruo Kirikae, Jeevan Bahadur Sherchand
Abstract
ObjectivesThe aim of this study was to describe the emergence in Nepal of clinical isolates of Klebsiella pneumoniae harboring both blaNDM-5 and blaOXA-181/-232.MethodsSix clinical isolates of K. pneumoniae highly resistant to carbapenems and aminoglycosides were obtained from inpatients in Nepal. Their whole genomes were sequenced by a next generation sequencer.ResultsThe minimum inhibitory concentrations of meropenem, amikacin and ciprofloxacin were ≥128 μg/ml, >1024 μg/ml and ≥256 μg/ml, respectively. All six isolates co-harbored blaNDM-5, blaOXA-181 or -232 and rmtB. Of them, 1 also harbored rmtF. The blaNDM-5, blaOXA-232 and rmtB in all six isolates were located on plasmids. Of the six isolates tested, one isolate harbored two copies of blaOXA-181 and rmtF on the chromosome.ConclusionsThis is the first report of clinical isolates of K. pneumoniae co-harboring blaNDM-5, blaOXA-181 or -232 and rmtB in Nepal. These strains were highly carbapenem- and aminoglycoside-resistant, and belonged to ST147 or ST395. Of them, ST147 isolate harbored two copies of blaOXA-181 on the chromosome.