Emergence and Spread of Carbapenem-Resistant and Aminoglycoside-Panresistant Complex Isolates Coproducing NDM-Type Metallo-β-Lactamase and 16S rRNA Methylase in Myanmar.

Surveillance of 10 hospitals and a regional public health laboratory in Myanmar identified 31 isolates of carbapenem-resistant complex harboring Of these isolates, 19 were highly resistant to aminoglycosides and harbored one or more genes encoding 16S rRNA methylases, including , , , and/or Of the 19 isolates, 16 were ST200, with on the chromosome and a plasmid harboring and , indicating that these isolates were clonally disseminated nationwide in Myanmar. The emergence of multidrug-resistant complex has become a public health threat worldwide. is a recently classified species belonging to complex. Here, we report a clonal dissemination of multidrug-resistant ST200 producing two types of New Delhi metallo-β-lactamase (NDM-type MBL), NDM-1 and -4, and three types of 16S rRNA methylases, ArmA, RmtC, and RmtE, in hospitals in Myanmar. The observation of these multidrug-resistant ST200 isolates stresses the urgency to continue molecular epidemiological surveillance of these pathogens in Myanmar and in South Asian countries.