Emergence of clinical isolates of highly carbapenem-resistant Klebsiella pneumoniae co-harboring blaNDM-5 and blaOXA-181 or -232 in Nepal. (March 2020)

• Record Type: Journal Article
• Authors: Sherchan, Jatan B.; Tada, Tatsuya; Shrestha, Shovita; Uchida, Hiroki; Hishinuma, Tomomi; Morioka, Shinichiro; Shahi, Rajesh K.; Bhandari, Sarita; Twi, Roshna T.; Kirikae, Teruo; Sherchand, Jeevan B.
• Is Part Of: International journal of infectious diseases. Volume 92(2020)
• Page Start: 247
• Page End: 252
• Publication Date: 2020-03
• Subjects: Klebsiella pneumoniae -- Multidrug resistance -- Carbapenemase -- 16S rRNA methylase; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2020.01.040
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Carbapenem-resistant Klebsiella pneumoniae were isolated in hospitals in Nepal. The isolates belonged to ST147 or ST395. The isolates belonging to ST395 co-harbored bla NDM-5, bla OXA-232 and rmtB . The isolate belonging to ST147 co-harbored bla NDM-5, bla OXA-181, rmtB and rmtF . The ST147 isolate harbored two copies of bla OXA-181 on the chromosome. Abstract: Objectives: The aim of this study was to describe the emergence in Nepal of clinical isolates of Klebsiella pneumoniae harboring both bla NDM-5 and bla OXA-181/-232 . Methods: Six 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. Results: The 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 bla NDM-5, bla OXA-181 or -232 and rmtB . Of them, 1 also harbored rmtF . The bla NDM-5, bla OXA-232 and rmtB in all six isolates were located on plasmids. Of the six isolates tested, one isolate harbored two copies of bla OXA-181 and rmtF on the chromosome. Conclusions: This is the first report of clinical isolates of K. pneumoniae co-harboring bla NDM-5, bla OXA-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 bla OXA-181 on the chromosome.