Carbapenem-Resistant in Southwest China: Molecular Analysis of Resistance and Risk Factors for Infections Caused by NDM-1-Producers.

Carbapenem-resistant (CRE) has been considered a serious global threat, but carbapenem resistance remains relatively uncommon in , especially in China. The aim of this study was to characterize carbapenem-resistant (CR-ECL) isolates from 2012 to 2016 in Southwest China. Our study revealed that 20 (15.2%) of the 132 CR-ECL isolates obtained from patients were identified as NDM-1, with most isolates carrying the IncFIIA plasmids. Notably, we initially observed that the strain co-harbored NDM-1 and IMP-8 carbapenemases simultaneously. Analysis of the genetic environment of these two genes has revealed that the highly conserved regions (a---) are associated with the dissemination of NDM-1, while IS26, , and could be involved in the spread of IMP-8. Molecular epidemiology studies showed the nosocomial outbreak caused by NDM-1-producing ST88. Transferring from another hospital and previous carbapenem exposure were identified as independent risk factors for the acquisition of NDM-1-producing These findings emphasize the need for intensive surveillance and precautions to monitor the further spread of NDM-1 in China.