Characterization of NDM-5 Carbapenemase-Encoding Gene ( ) - Positive Multidrug Resistant Commensal from Diarrheal Patients.

PURPOSE

The multidrug resistance Enterobacteriaceae cause many serious infections resulting in prolonged hospitalization, increased treatment charges and mortality rate. In this study, we characterized -positive multidrug resistance commensal (CE) isolated from diarrheal patients in Kolkata, India.

METHODS

Three CE strains were isolated from diarrheal stools, which were negative for different pathogroups of diarrheagenic (DEC). The presence of carbapenemases encoding genes and other antimicrobial resistance genes (ARGs) was detected using PCR. The genetic arrangement adjoining was investigated by plasmid genome sequencing. The genetic relatedness of the strains was determined by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) methods.

RESULTS

In addition to colistin, the -positive CE strains showed resistance to most of the antibiotics. Higher MICs were detected for ciprofloxacin (>32 mg/L) and imipenem (8 mg/L). Molecular typing revealed that three CE strains belonged to two different STs (ST 101 and ST 648) but they were 95% similar in the PFGE analysis. Screening for ARGs revealed that CE strains harbored , , , , , , and . In conjugation experiment, transfer frequencies ranged from 2.5×10 to 8.4x10. The gene was located on a 94-kb pNDM-TC-CE-89 type plasmid, which is highly similar to the IncFII plasmid harboring an IS26-IS30- - --IS structure.

CONCLUSION

To the best of our knowledge, this is the first report on carbapenem resistance involving the gene in CE from diarrheal patients. The circulation of gene in CE is worrisome, since it has the potential to transfer gene to other enteric pathogens.