Abstract
Objectives: The aim of this research was to investigate the clinical and microbiological characteristics of a case of community-acquired carbapenem-resistant Escherichia coli isolated from a patient with a bloodstream infection in China.Methods: Escherichia coli Huamei202001 was recovered from the first blood culture from a patient hospitalised in China. An antimicrobial susceptibility test was performed, and the genome was sequenced on an Illumina HiSeq X 10 platform with a 150-bp paired-end approach. The generated sequence reads were assembled using Unicycler, and the whole genome sequence data were analysed using bioinformatics tools. Moreover, the patient and her main family members obtained a faecal sample screening test for CRE, the positive strain was further isolated and the identification and antimicrobial susceptibility testing was performed.Results: Escherichia coli Huamei202001 belonged to sequence type 410. In addition, a blaNDM-5-encoding IncX3-type plasmid was responsible for the spreading of carbapenem resistance. Only the patient was detected as having a positive faecal sample screening test for CRE. Strain Fec01 was identified as E. coli, and the antibiotic susceptibility profile was the same as that of E. coli Huamei202001.Conclusions: Escherichia coli Huamei202001 is defined as community-acquired carbapenem-resistant Enterobacteriaceae. The clone ST410 that harbours the blaNDM-5-encoding IncX3-type plasmid is causing new high-risk clones globally. Thus, infection control measures should be strengthened to curb the dissemination of IncX3.
Highlights
The emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) has created an escalating global threat with the dissemination of carbapenemase genes
Escherichia coli Huamei202001 was recovered from the first blood culture collected on January 7, 2020, from a 59-year-old female patient hospitalised at Hwa Mei Hospital, University of Chinese Academy of Sciences, Zhejiang Province, China
On day 9, the patient complained of numbness of the extremities, polymyxin neurotoxicity was considered and the dose of polymyxin B was reduced to 500,000 U q12 h, with the white blood cell count being 12 × 109/L, C-reactive protein (CRP) 49.47 mg/L and procalcitonin 0.28 ng/ml
Summary
The emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) has created an escalating global threat with the dissemination of carbapenemase genes. The most common carbapenemase genes include blaKPC, blaNDM, blaVIM, blaIMP, and blaOXA-48-like [1]. A nationwide survey conducted in China showed that acquisition of two carbapenemase genes, blaKPC-2 and blaNDM, was responsible for phenotypic resistance in 90% of the CRE strains tested (58 and 32%, respectively) [2]. NDM-5-producing ST167 [4], ST290 [5], ST361 [6], and ST410 [7, 8] Escherichia coli have been reported. The blaNDM5-encoding IncX3-type plasmid is responsible for disseminating carbapenem-resistant E. coli ST410, which has developed into a new high-risk clone globally
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
