ABSTRACT
Four NDM-1-producing Enterobacteriaceae strains (three Klebsiella pneumoniae and one Citrobacter koseri) were isolated between 2009 and 2011 through a nationwide surveillance for carbapenem-resistant Enterobacteriaceae in Croatia to study the molecular genetic background of blaNDM and the responsible plasmid types. Phenotypically, the clinical strains proved to be multidrug resistant. All strains remained susceptible to tigecycline and colistin. The clinical strains harbored variable antibiotic resistance determinants, notably, blaNDM-1, blaTEM-1, blaSHV-1, blaSHV-12, blaOXA-1, blaOXA-9, blaCTX-M-15, blaCMY-4, qnrB1, and aac(6')Ib-cr in different combinations. Two K. pneumoniae belonged to sequence type ST15 and one strain to ST16. As for the plasmid types, C. koseri and one of the ST15 K. pneumoniae carried IncR, and the second ST15 K. pneumoniae carried IncR and colE. The K. pneumoniae ST16 strain hosted A/C and colE plasmids. The blaNDM-1 gene was detected on conjugative high-molecular-weight plasmids, namely, A/C and IncR types. It is noteworthy that this is the first description of K. pneumoniae ST16 expressing NDM-1 in Europe. Remarkably, our study underscores the importance of the IncR plasmid as a reservoir of multidrug resistance. To the best of our knowledge, the IncR plasmid carrying blaNDM-1 in C. koseri is reported for the first time.
Subject(s)
Anti-Bacterial Agents/pharmacology , Citrobacter koseri/genetics , DNA, Bacterial/genetics , Drug Resistance, Multiple, Bacterial/genetics , Klebsiella pneumoniae/genetics , Plasmids/metabolism , beta-Lactamases/genetics , Carbapenems/pharmacology , Citrobacter koseri/drug effects , Citrobacter koseri/enzymology , Citrobacter koseri/isolation & purification , Colistin/pharmacology , Conjugation, Genetic , Croatia , Enterobacteriaceae Infections/drug therapy , Enterobacteriaceae Infections/microbiology , Gene Expression , Gene Transfer, Horizontal , Humans , Isoenzymes/genetics , Isoenzymes/metabolism , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/enzymology , Klebsiella pneumoniae/isolation & purification , Microbial Sensitivity Tests , Minocycline/analogs & derivatives , Minocycline/pharmacology , Plasmids/chemistry , Sequence Analysis, DNA , Tigecycline , beta-Lactamases/metabolismABSTRACT
Identification of viridans group streptococci (VGS) to the species level is difficult because VGS exchange genetic material. We performed multilocus DNA target sequencing to assess phylogenetic concordance of VGS for a well-defined clinical syndrome. The hierarchy of sequence data was often discordant, underscoring the importance of establishing biological relevance for finer phylogenetic distinctions.