Emergence and Spread of Carbapenem-Resistant and Aminoglycoside-Panresistant Enterobacter cloacae Complex Isolates Coproducing NDM-Type Metallo-β-Lactamase and 16S rRNA Methylase in Myanmar
Emergence and Spread of Carbapenem-Resistant and Aminoglycoside-Panresistant Enterobacter cloacae Complex Isolates Coproducing NDM-Type Metallo-β-Lactamase and 16S rRNA Methylase in Myanmar
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DOI：
10.1128/msphere.00054-20
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发表时间：
2020-03-01
期刊：
影响因子：
4.8
通讯作者：
Tin, Htay Htay
中科院分区：
文献类型：
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作者：
Oshiro, Satoshi;Tada, Tatsuya;Tin, Htay Htay
对缅甸10家医院和一个区域公共卫生实验室的监测发现了31株含有bla（ndm型）的耐碳青霉烯类阴沟肠杆菌复群。在这些分离株中，19株对氨基糖苷具有高度耐药性，并携带一个或多个编码16S rRNA甲基化酶的基因，包括armA、rmtB、rmtC和/或rmtE。在19株分离株中，16株为湘方肠杆菌ST200，染色体上存在armA，质粒携带bla（NDM-1）和rmtC，表明这些分离株在缅甸全国范围内无性传播。多重耐药阴沟肠杆菌复合体的出现已成为全球公共卫生威胁。香方肠螨是阴沟肠螨复合体中新近分类的一种。在这里，我们报告了多药耐药的香方E. ST200在缅甸医院的克隆传播，产生两种新德里金属β -内酰胺酶（NDMtype MBL）， NDM-1和-4，以及三种16S rRNA甲基化酶，ArmA， RmtC和RmtE。对这些多重耐药香方大肠杆菌ST200分离株的观察强调了在缅甸和南亚国家继续对这些病原体进行分子流行病学监测的紧迫性。
Surveillance of 10 hospitals and a regional public health laboratory in Myanmar identified 31 isolates of carbapenem-resistant Enterobacter cloacae complex harboring bla(NDM-type). Of these isolates, 19 were highly resistant to aminoglycosides and harbored one or more genes encoding 16S rRNA methylases, including armA, rmtB, rmtC, and/or rmtE. Of the 19 isolates, 16 were Enterobacter xiangfangensis ST200, with armA on the chromosome and a plasmid harboring bla(NDM-1) and rmtC, indicating that these isolates were clonally disseminated nationwide in Myanmar.IMPORTANCE The emergence of multidrug-resistant E. cloacae complex has become a public health threat worldwide. E. xiangfangensis is a recently classified species belonging to E. cloacae complex. Here, we report a clonal dissemination of multidrug-resistant E. xiangfangensis ST200 producing two types of New Delhi metallo-beta-lactamase (NDMtype MBL), NDM-1 and -4, and three types of 16S rRNA methylases, ArmA, RmtC, and RmtE, in hospitals in Myanmar. The observation of these multidrug-resistant E. xiangfangensis ST200 isolates stresses the urgency to continue molecular epidemiological surveillance of these pathogens in Myanmar and in South Asian countries.