Phylogenetic diversity and mutational analysis of New Delhi Metallo-β-lactamase (NDM) producing strains from pediatric patients in Pakistan.

The evolution of NDM genes ( ) in is accounted for expansive multidrug resistance (MDR), causing severe infections and morbidities in the pediatric population. This study aimed to analyze the phylogeny and mutations in NDM variants of recovered from the pediatric population. Carbapenem-resistant clinical strains of were identified using microbiological phenotypic techniques. PCR technique used to amplify the genes, identified on agarose gel, and analyzed by DNA sequencing. The amino acid substitutions were examined for mutations after aligning with wild types. Mutational and phylogenetic analysis was performed using Lasergene, NCBI blastn, Clustal Omega, and MEGA software, whereas PHYRE2 software was used for the protein structure predictions. PCR amplification of the genes detected 113 clinical strains of with the contribution of (46%), (3.5%), and (50%) variants. DNA sequencing of variants showed homology to the previously described , and genes available at GenBank and NCBI database. In addition, the mutational analysis revealed in frame substitutions of and in and respectively. The was ortholog with related sequences of available at GenBank. The phylogenetic analysis indicated that the NDM gene variants resemble other microbes reported globally with some new mutational sites.