Whole-Genome Sequencing of Clinically Isolated Carbapenem-Resistant Enterobacterales Harboring Genes in Thailand, 2016-2019.

Mobile colistin-resistant genes () have become an increasing public health concern. Since the first report of in Thailand in 2016, perspective surveillance was conducted to explore the genomic characteristics of clinical carbapenem-resistant Enterobacterales (CRE) isolates harboring in 2016-2019. Thirteen (0.28%) out of 4,516 CRE isolates were found to carry genes, including 69.2% (9/13) of and 30.8% (4/13) of isolates. Individual was detected in eight (61.5%) isolates, whereas the co-occurrence of and was seen in only one isolate (7.7%). No CRE were detected carrying , or through to . Analysis of plasmid replicon types carrying revealed that IncX4 was the most common (61.5%; 8/13), followed by IncI2 (15.4%; 2/13). The minimum inhibitory concentration values for colistin were in the range of 4-16 μg/ml for all CRE isolates harboring , suggesting they have 100% colistin resistance. Clermont phylotyping of nine -harboring carbapenem-resistant isolates demonstrated phylogroup C was predominant in ST410. In contrast, ST336 belonged to CC17, and the KL type 25 was predominant in carbapenem-resistant isolates. This report provides a comprehensive insight into the prevalence of -carrying CRE from patients in Thailand. The information highlights the importance of strengthening official active surveillance efforts to detect, control, and prevent -harboring CRE and the need for rational drug use in all sectors.