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The bacterial enzyme New Delhi metallo-β-lactamase hydrolyzes almost all β-lactam antibiotics, including carbapenems, which are drugs of last resort for severe bacterial infections. The spread of carbapenem-resistant  Enterobacteriaceae  that carry the New Delhi metallo-β-lactamase gene,  bla  NDM , poses a serious threat to public health. In this study, we genetically characterized eight carbapenem-resistant  Escherichia coli  isolates from a tertiary care hospital in Yangon, Myanmar. The eight isolates belonged to five multilocus-sequence types and harbored multiple antimicrobial-resistance genes, resulting in resistance against nearly all of the antimicrobial agents tested, except colistin and fosfomycin. Nine plasmids harboring  bla  NDM  genes were identified from these isolates. Multiple  bla  NDM  genes were found in the distinct Inc-replicon types of the following plasmids: an IncA/C 2  plasmid harboring  bla  NDM-1  ( n  = 1), IncX3 plasmids harboring  bla  NDM-4  ( n  = 2) or  bla  NDM-7  ( n  = 1), IncFII plasmids harboring  bla  NDM-4  ( n  = 1) or  bla  NDM-5  ( n  = 3), and a multireplicon F plasmid harboring  bla  NDM-5  ( n  = 1). Comparative analysis highlighted the diversity of the  bla  NDM -harboring plasmids and their distinct characteristics, which depended on plasmid replicon types. The results indicate circulation of phylogenetically distinct strains of carbapenem-resistant  E .  coli  with various plasmids harboring  bla  NDM  genes in the hospital.

Genetic characterization of blaNDM-harboring plasmids in carbapenem-resistant Escherichia coli from Myanmar