Journal Article

Increasing prevalence and dissemination of NDM-1 metallo-β-lactamase in India: data from the SMART study (2009)

Christine Lascols, Meredith Hackel, Steven H. Marshall, Andrea M. Hujer, Sam Bouchillon, Robert Badal, Daryl Hoban and Robert A. Bonomo

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 66, issue 9, pages 1992-1997
Published in print September 2011 | ISSN: 0305-7453
Published online June 2011 | e-ISSN: 1460-2091 | DOI: https://dx.doi.org/10.1093/jac/dkr240
Increasing prevalence and dissemination of NDM-1 metallo-β-lactamase in India: data from the SMART study (2009)

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Objectives

To investigate the β-lactamase background of ertapenem non-susceptible isolates for the presence of the most commonly detected carbapenemase genes, blaKPC, blaOXA-48 and blaVIM, and the newly described blaNDM-1.

Methods

Two hundred and thirty-five ertapenem-non-susceptible (MIC ≥0.5 mg/L) isolates of Enterobacteriaceae from the worldwide Study for Monitoring Antimicrobial Resistance Trends (SMART) 2009 programme were screened using a multiplex PCR for the presence of blaKPC, blaOXA-48, blaVIM and blaNDM-1 genes. Extended-spectrum β-lactamase (ESBL) and AmpC genes (blaESBL and blaAmpC) were identified using the Check-MDR CT101 microarray. DNA sequencing was performed to identify the blaESBL, blaKPC and blaNDM-1 genes. Molecular typing was also performed to genetically characterize these isolates.

Results

Sixty-six isolates (28%) had a carbapenemase gene, with blaNDM-1 identified in 33 isolates including 2 isolates carrying both blaNDM-1 and blaOXA-48; other carbapenemase genes found included blaKPC (n = 23), blaVIM (n = 7) and blaOXA-48 (n = 3). All blaNDM-1-carrying isolates were from patients in India and comprised five different species. With the exception of one isolate carrying only blaNDM-1, all blaNDM-1 carbapenemase-possessing isolates carried additional β-lactamases in various combinations: blaESBL and blaAmpC (n = 18); blaESBL (n = 10); blaESBL, blaAmpC and blaOXA-48 (n = 2); and blaAmpC (n = 2). Except for blaOXA-48-carrying isolates, novel multilocus sequence types or enterobacterial repetitive intergenic consensus PCR patterns were observed along with clonal dissemination within and among sites.

Conclusions

A range of carbapenemase genes, associated with diverse ESBLs and/or AmpC backgrounds, were found among Enterobacteriaceae isolated during the study. Many of these ertapenem non-susceptible strains were clonally related and carried various combinations of β-lactamases.

Keywords: carbapenemases; Enterobacteriaceae; microarray analysis

Journal Article.  3623 words. 

Subjects: Medical Oncology ; Critical Care

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