Dissemination of carbapenemase-producing Enterobacteriaceae harbouring blaNDM or blaIMI in local market foods of Yangon, Myanmar

Rathina Kumar Shanmugakani,Noriko Sakamoto,Hpoo Pwint Myo Win,Yo Sugawara,Hideharu Hagiya,Kazunori Tomono,Akiko Ueda,Dan Takeuchi,Mya Mya Aye,Yukihiro Akeda,Moh Moh Htun,Shigeyuki Hamada,Isao Nishi

doi:10.1038/s41598-019-51002-5

Rathina Kumar Shanmugakani, Noriko Sakamoto + Show 11 more

Open Access

https://doi.org/10.1038/s41598-019-51002-5

Copy DOI

Abstract

The spread of carbapenemase-producing Enterobacteriaceae (CPE) poses a serious threat to clinical practice and public health. These bacteria are present both in clinical settings and non-clinical environments. The presence of CPE in food stuffs has been reported, but sporadically so. Here, we screened for CPE in meat, seafood, and vegetable samples from local markets of Yangon, Myanmar. We obtained 27 CPE isolates from 93 food samples and identified 13 as Escherichia coli, six as Klebsiella pneumoniae, seven as Enterobacter cloacae complex, and one as Serratia marcescens. All except the E. cloacae complex harboured the carbapenemase genes blaNDM-1 or blaNDM-5, while all Enterobacter isolates carried the carbapenemase gene blaIMI-1. The blaIMI-1 gene was located in putative mobile elements EcloIMEX-2, -3, or -8. Using multi-locus sequence typing, E. coli, K. pneumoniae, and E. cloacae complex isolates were classified into 10, six, and five different sequence types, respectively. Our results demonstrate that diverse organisms with various carbapenemase genes are widespread in the market foods in Yangon, highlighting the need for promoting proper food hygiene and effective measures to prevent further dissemination.

Highlights

The spread of carbapenemase-producing Enterobacteriaceae (CPE) poses a serious threat to clinical practice and public health
Of the 93 food samples from eight markets, we identified 20 CPE-positive samples (21.5%)
Using the carbapenem-inactivation method (CIM), we identified seven carbapenemase-positive isolates of Enterobacter cloacae complex that are negative for blaNDM, blaKPC, blaIMP, or blaOXA-48 according to a PCR-dipstick test

Summary

Introduction

The spread of carbapenemase-producing Enterobacteriaceae (CPE) poses a serious threat to clinical practice and public health. These bacteria are present both in clinical settings and non-clinical environments. Carbapenem-resistant Enterobacteriaceae have become a global public-health concern because these bacteria cause high mortality and are multidrug-resistant[1] This resistance is mainly due to the production of carbapenemases, which hydrolyse carbapenem antibiotics. We found closely related strains in sewage water outside the hospital[10], implying that CPE in clinical settings could reach the external environment. These findings prompted us to investigate the extent of CPE dissemination in local communities. We focused on the spread of CPE in local markets

Methods

Results

Conclusion