Emergence of New Delhi Metallo-β-Lactamase (NDM-5) in from Neonates in a Nigerian Hospital.

Outbreaks of infection occur more often than they are reported in most developing countries, largely due to poor diagnostic services. A species bacteremia outbreak in a newborn unit with high mortality was recently encountered at a location being surveilled for childhood bacteremia. These surveillance efforts offered the opportunity to determine the cause of this neonatal outbreak. In this report, we present the whole-genome sequences of New Delhi metallo-β-lactamase (NDM-5)-containing subsp. bloodstream isolates from a neonatal bacteremia outbreak at a tertiary hospital in Nigeria and as part of the largest collection of bloodstream isolates from children in Africa. Comparative analysis of the genetic environment surrounding the NDM-5 genes revealed nearly perfect sequence identity to -bearing IncX3-type plasmids from other members of the Carbapenem-resistant is of global health importance, yet there is a paucity of genome-based studies in Africa. Here we report fatal blood-borne NDM-5-producing subsp. infections from Nigeria, Africa. New Delhi metallo-β-lactamase (NDM)-producing spp. are responsible for high mortality and morbidity, with the NDM-5 variant showing elevated carbapenem resistance. The prevalence of NDM-5 in has been limited primarily to , with only one isolate being collected from Africa. During an outbreak of sepsis in a teaching hospital in Nigeria, five NDM-5-producing subsp. sequence type 476 isolates were identified. Given the increased resistance profile of these strains, this study highlights the emerging threat of dissemination in hospital environments. The observation of these NDM-5-producing isolates in Africa stresses the urgency to improve monitoring and clinical practices to reduce or prevent the further spread of resistance.