J. Craig Venter Institute, Rockville, Maryland, USA
J. Craig Venter Institute, Rockville, Maryland, USA.
mSphere. 2019 Mar 13;4(2):e00685-18. doi: 10.1128/mSphere.00685-18.
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.
在大多数发展中国家，感染爆发的次数比报告的要多，这主要是由于诊断服务不佳。最近，在一个正在监测儿童菌血症的地方，一个新生儿病房发生了高死亡率的 种菌血症爆发。这些监测工作提供了确定新生儿爆发原因的机会。在本报告中，我们展示了来自尼日利亚一家三级医院新生儿菌血症爆发的含有新德里金属β-内酰胺酶（NDM-5）的 亚种 血流分离株的全基因组序列，这是非洲最大的儿童血流分离株集合的一部分。对 NDM-5 基因周围遗传环境的比较分析显示，与来自该 耐碳青霉烯肠杆菌科 的其他成员的携带 IncX3 型质粒具有几乎完全的序列同一性。耐碳青霉烯肠杆菌科的 种 对全球健康具有重要意义，但在非洲几乎没有基于基因组的研究。在这里，我们报告了来自非洲尼日利亚的致命血源性 NDM-5 产生的 亚种 感染。产生新德里金属β-内酰胺酶（NDM）的 spp. 是高死亡率和发病率的原因，其中 NDM-5 变体显示出更高的碳青霉烯耐药性。NDM-5 在 中的流行主要局限于 ，仅从非洲收集到一个分离株。在尼日利亚一家教学医院的败血症爆发期间，鉴定出了五个产生 NDM-5 的 亚种 序列型 476 分离株。鉴于这些菌株的耐药谱增加，本研究强调了 传播在医院环境中出现的威胁。在非洲观察到这些产生 NDM-5 的分离株强调了迫切需要改善监测和临床实践，以减少或防止耐药性的进一步传播。
