Department of Microbiology, Tokyo Metropolitan Institute of Public Health , Shinjuku-ku, Tokyo, Japan.
Division of Laboratory Medicine and Companion Diagnostics, Department of Pathology and Microbiology, Nihon University School of Medicine , Itabashi-ku, Tokyo, Japan.
mSphere. 2023 Aug 24;8(4):e0014723. doi: 10.1128/msphere.00147-23. Epub 2023 Jul 14.
is an Enterobacterales species that was originally identified as a plant growth-promoting, Gram-negative bacterium. Recently, this species has been recognized as relevant to opportunistic human and nosocomial infections in clinical settings. Its frequent misidentification as other Enterobacterales species from clinical examination occasionally causes a delay in the identification of nosocomial outbreaks. Here, we report the emergence of New Delhi metallo-β-lactamase (NDM)-producing isolated from hospitalized pediatric patients and hospital environments in Tokyo, Japan. In our case, these isolates were found during an investigation of carbapenem-resistant Enterobacterales in relation to nosocomial infections. Whole-genome sequencing is useful for overcoming the difficulty of species identification. Furthermore, we found that was carried by an IncA/C plasmid (approximately 170 kbp), which was transferrable from the clinical isolates to the recipient strain J53. Our study demonstrated that behaves as a carrier of -harboring plasmids, potentially disseminating resistance to carbapenems among Enterobacterales. IMPORTANCE Early detection of nosocomial outbreaks is important to minimize the spread of bacteria. When an outbreak is caused by multidrug-resistant bacteria such as carbapenem-resistant Enterobacterales, a delay in findings makes it difficult to control it because such bacteria often spread not only among human patients but also in hospital environments. , an Enterobacterales species that has recently been found to be relevant to clinical settings, is often misidentified as other bacteria in clinical laboratories. Here, we found NDM-producing in hospitalized pediatric patients and their environment in Tokyo, Japan. Given that the isolates carried -harboring transferrable plasmids, the influence of such bacteria could be greater with the mediation of horizontal transfer of carbapenem resistance. Our findings suggest that should be recognized as an NDM-carrier, for which more attention should be paid in clinical settings.
是肠杆菌目(Enterobacterales)的一种细菌,最初被鉴定为一种具有植物促生长作用的革兰氏阴性菌。最近,该物种已被认为与临床环境中的机会性人类和医院获得性感染有关。由于其在临床检查中经常被错误鉴定为其他肠杆菌目物种,偶尔会导致医院感染暴发的鉴定延迟。在这里,我们报告了在日本东京的住院儿科患者和医院环境中分离出的产生新德里金属β-内酰胺酶(NDM)的 。在我们的病例中,这些分离株是在调查与医院感染有关的耐碳青霉烯类肠杆菌科细菌时发现的。全基因组测序有助于克服物种鉴定的困难。此外,我们发现 由 IncA/C 质粒(约 170 kbp)携带,该质粒可从临床分离株转移至受体菌株 J53。我们的研究表明, 作为携带 - 质粒的载体,有可能在肠杆菌科中传播对碳青霉烯类药物的耐药性。 重要性 早期发现医院感染暴发对于最大限度地减少细菌传播非常重要。当感染是由耐多药细菌引起的,如耐碳青霉烯类肠杆菌科细菌时,由于这种细菌不仅在人类患者中传播,而且在医院环境中传播,因此发现的延迟使得难以控制它。 ,一种最近在临床环境中发现与临床相关的肠杆菌目物种,在临床实验室中经常被错误鉴定为其他细菌。在这里,我们在日本东京的住院儿科患者及其环境中发现了产 NDM 的 。鉴于分离株携带 - 携带可转移质粒,在碳青霉烯类耐药性的水平转移介导下,此类细菌的影响可能更大。我们的研究结果表明, 应被视为 NDM 载体,在临床环境中应更加关注。