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Characterization of blaNDM-1- and blaSHV-12-Positive IncX3 Plasmid in an Enterobacter Hormaechei New Sequence Type 1000 from China

Authors Li P, Lin Y, Hu X, Liu Y, Xue M, Yang L, Li J, Zha L, Wang K, Qi K, Qiu S, Li P, Song H

Received 17 September 2019

Accepted for publication 20 December 2019

Published 13 January 2020 Volume 2020:13 Pages 145—153

DOI https://doi.org/10.2147/IDR.S231366

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Eric Nulens


Peihan Li, 1, 2,* Yanfeng Lin, 1, 2,* Xiaofeng Hu, 2,* Yuqi Liu, 1, 2 Mei Xue, 3 Lang Yang, 1, 2 Jinhui Li, 2 Lei Zha, 2 Kaiying Wang, 1 Kezong Qi, 3 Shaofu Qiu, 2 Peng Li, 2 Hongbin Song 2

1Academy of Military Medical Sciences, Academy of Military Sciences, Beijing, People’s Republic of China; 2Center for Disease Control and Prevention of PLA, Beijing, People’s Republic of China; 3Anhui Province Key Laboratory of Veterinary Pathobiology and Disease Control, Anhui Agricultural University, Anhui, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Peng Li; Hongbin Song
Center for Disease Control and Prevention of PLA, 20 DongDa Street, Fengtai District, Beijing 100071, People’s Republic of China
Tel/Fax +86-10-66948475
Email jiekenlee@126.com; hongbinsong@263.net

Purpose: Carbapenem-resistant Enterobacter cloacae complex has been reported worldwide and becomes a new challenge for clinical management. The present study was to characterize the IncX3 plasmid encoding blaNDM-1 and blaSHV-12 gene in E. hormaechei sequence.
Materials and Methods: EcHK001 was recovered from the sputum sample of a patient. Species identification and antimicrobial susceptibility testing were performed using the VITEK 2 system, while further classification was carried out by hsp60 typing. The presence of NDM-1 was detected by PCR and sequencing. Conjugation experiments and southern blotting were carried out to determine the transferability of the NDM-1-carrying plasmid. Whole-genome sequencing and analysis were conducted to better understand the molecular characteristics of the multi-drug resistant isolate.
Results: Strain EcHK001 was classified as E. hormaechei of new sequence type 1000. Multiple drug-resistant genes were detected. The blaNDM-1 and blaSHV-12 genes were located on a self-transferable IncX3 plasmid. Synonymous mutations were identified in the genes encoding TEM-1 and ACT-17. Phylogenetic analysis indicated that EcHK001 clustered into a different clade from domestic strains.
Conclusion: The rapid spread of the recurrent IncX3 plasmid highlights the need for continuous surveillance of the NDM-1 dissemination. The presence of mutations in existing carbapenem-resistant genes may generate potential new variants and raise serious challenges for clinical treatment.

Keywords: multidrug-resistant, NDM-1, SHV-12, enterobacter hormaechei

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