Isolation of the first New Delhi metallo-ß-lactamase-1 (NDM-1)-producing and colistin-resistant Klebsiella pneumoniae sequence type ST15 from a digestive carrier in Albania, May 2018

Silva Tafaj, Floriana Gona, Perlat Kapisyzi, Alma Cani, Alban Hatibi, Silvia Bino, Albana Fico, Andi Koraqi, Gentian Kasmi, Daniela Cirillo

Research output: Contribution to journalArticle

Abstract

Objectives: Carbapenemases represent a public health threat, as they can spread through horizontal gene transfer and cause outbreaks. New Delhi metallo-ß-lactamase-1 (NDM-1) is a metallo-ß-lactamase that has spread rapidly in the last decade, causing worldwide alarm. This study aimed to describe the first isolate of NDM-1-producing and extensively drug resistant Klebsiella pneumoniae in Albania, its clinical context and genetic characterization. Methods: Strain was isolated from both oral and rectal intensive care unit admission screening swabs of a 70-year-old male patient with no history of international travel in the previous 6 months. Sequencing was performed by Illumina NextSeq500 platform, with a paired-end run of 2 by 150 bp, after Nextera XT paired-end library preparation. Sequencing reads were assembled using SPAdes Genome (version 3.6.1) with accurate de novo settings. The assembled contigs were uploaded into the online tools: BIGSdb-Kp, ResFinder and PlasmidFinder. Results: Isolate was resistant to all tested antibiotics but tigecycline and trimethoprim-sulfamethoxazole. Sequencing revealed the presence of acquired resistance genes conferring resistance to β-lactams (bla NDM-1 , bla CMY-6 , bla CTX-M-15 and bla SHV-28 ), aminoglycosides (rmtC, aac(6′)-Ib3), fluoroquinolones (oqxA, oqxB, aac(6')-Ib-cr), fosfomycin (fosA) and sulfonamides (sul1). The bla NDM-1 gene was located on an IncA/C2 plasmid. Plasmid mediated mcr-1 to mcr-8 genes were absent in both isolates. Resistance to colistin was due to an amino acid substitution (Thr157Pro) in PmrB protein. Conclusions: NDM-1-producing Enterobacteriaceae are spreading in the Balkans. Identification of NDM-1-producing and extensively drug resistant K. pneumoniae ST15 in Albania is a cause for serious concern. There should be a continuous national and Balkan multinational surveillance of bla NDM-1 -carrying isolates.

Original languageEnglish
Pages (from-to)142-144
Number of pages3
JournalJournal of Global Antimicrobial Resistance
Volume17
DOIs
Publication statusPublished - Jun 2019

Keywords

  • Colistin resistance
  • Digestive carrier
  • Extensively drug resistant
  • Klebsiella pneumoniae
  • MBL (metallo-ß-lactamase)
  • NDM-1 (New Delhi metallo-ß-lactamase-1)

ASJC Scopus subject areas

  • Microbiology
  • Immunology and Allergy
  • Immunology
  • Microbiology (medical)

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