Complete Nucleotide Sequence of Plasmids of Two Escherichia coli Strains Carrying blaNDM–5 and blaNDM–5 and blaOXA–181 From the Same Patient
Vittoria Mattioni Marchetti, Ibrahim Bitar, Alessandra Mercato, Elisabetta Nucleo, Annalisa Bonomini, Palmino Pedroni, Jaroslav Hrabák, Roberta Migliavacca
Abstract
Aim of this study was to genetically characterize two carbapenemase-producing Escherichia coli strains obtained from a pediatric patient affected by diarrhea, expressing OXA-181 and/or NDM-5 type enzymes. The above microorganisms were collected in the same Desenzano hospital (Northern Italy) where the blaNDM-5 gene was detected for the first time in Italy three years ago. One strain (5P), belonged to sequence type ST405/ST477 (according to Pasture/Oxford schemes) and serotype O102:H6. It was characterized by a 130562bp multi-replicon plasmid IncFII/IncFIA/IncFIB (pVSI_NDM-5) enclosing two main antibiotic resistance islands: i) ARI-I, 10030bp in size, carried genes coding for β-lactam- (blaOXA-1, blaCTX-M-15), fluoroquinolone/aminoglycoside- (aac(6’)-lb-cr) and phenicol- resistance (catB3), ii) ARI-II, 15326 bp in size, carried genes coding for sulphonamide- (sul1), β-lactam- (blaNDM-5, blaTEM-1B), phenicol- (catB3), trimethoprim- (dfrA17), antiseptic- (qacEΔ1) and aminoglycoside- (aadA5, rmtB) resistance. The other isolate (5M), belonged to sequence type ST2659/ST759 and serotype O50/02:H18, and carried four plasmids: a 153866bp multi-replicon IncFII/IncFIA/IncFIB (pISV_IncFII_NDM-5), an 89866bp IncI1 plasmid, a 51480bp IncX3 plasmid (pISV_IncX3_OXA181), and a 41143bp IncI plasmid (pISV_IncI_CMY-42). pISV_IncFII_NDM-5 carried two main antibiotic resistance islands: i) ARI-III, 12220bp in size, carried genes coding for β-lactam- (blaOXA-1), fluoroquinolone/aminoglycoside- (aac(6’)-lb-cr), tetracycline- (tet(B)) and phenicol- resistance (catB3,catA1), and ii) ARI-IV, 26527bp in size, carried determinants coding for macrolide- (erm(B), mph(A)), sulphonamide- (sul1), beta-lactam- (blaNDM-5, blaTEM-1B), trimethoprim- (dfrA14, dfrA12), antiseptic- (qacEΔ1) and aminoglycoside- resistance (aadA5). pISV_IncI_CMY-42 harboured the blaCMY-42 gene coding for beta-lactam resistance, pISV_IncX3_OXA181 harboured genes encoding fluoroquinolone- (qnrS1) and beta-lactams- resistance (blaOXA-181). In conclusion, the detection of two different NDM-5 E. coli strains from a pediatric patient with a history of travel to the Far East countries strongly highlight an increasing trend and risk of importation from such areas.