English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

One of the most demanding challenges in infection control is the worldwide dissemination of multidrug-resistant (MDR) bacteria in clinical settings. Especially the increasing prevalence of carbapenemase producing Gram-negative pathogens poses an urgent threat to public health, as these enzymes confer resistance to almost all β-lactam antibiotics including carbapenems. In this study, we report a prolonged nosocomial outbreak of various NDM-1-producing  Enterobacterales  species due to clonal spread and cross-species exchange of plasmids and possibly transposons. Between July 2015 and September 2017, a total of 51 carbapenemase-positive isolates were collected from 38 patients and three environmental sources in a single German hospital. Combining molecular typing methods and whole genome sequencing, the metallo-β-lactamase gene  bla  NDM–1  was found to be present in 35 isolates of which seven additionally carried the carbapenemase gene  bla  KPC–2 . Core genome MLST (cgMLST) revealed different clusters of closely related isolates of  Escherichia coli ,  Klebsiella pneumoniae ,  Citrobacter freundii ,  Morganella morganii  or  Enterobacter cloacae  indicating clonal spread. The detailed reconstruction of the plasmid sequences revealed that in all outbreak-associated isolates  bla NDM–1   was located on similar composite transposons, which were also very similar to Tn 125  previously described for  Acinetobacter baumannii . In contrast to Tn 125 , these structures were flanked by IS 26  elements, which could facilitate horizontal gene transfer. Moreover, the identical plasmid was found to be shared by  E. coli  and  M. morganii  isolates. Our results highlight the importance of detailed genome-based analyses for complex nosocomial outbreaks, allowing the identification of causal genetic determinants and providing insights into potential mechanisms involved in the dissemination of antibiotic resistances between different bacterial species.

IS26-Mediated Transfer of blaNDM–1 as the Main Route of Resistance Transmission During a Polyclonal, Multispecies Outbreak in a German Hospital