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Prevalence and molecular characterisation of New Delhi metallo-β-lactamases NDM-1, NDM-5, NDM-6 and NDM-7 in multidrug-resistant Enterobacteriaceae from India.
Int J Antimicrob Agents. 2014 Jul; 44(1):30-7.IJ

Abstract

The growing prevalence of carbapenem resistance in Enterobacteriaceae worldwide is a major concern. New Delhi metallo-β-lactamase (NDM)-mediated carbapenem resistance has been identified in Enterobacteriaceae from numerous countries including those of the Indian subcontinent. Currently, seven NDM β-lactamase variants (NDM-1 to -7) have been identified. This study evaluated the detection and molecular characterisation of NDM variants in Enterobacteriaceae at a tertiary care hospital in India. A total of 464 isolates were tested; 57 (12.3%) were resistant or showed reduced susceptibility to imipenem and meropenem. All carbapenem-resistant isolates were blaNDM-positive by PCR, but 13 isolates bore variants that differed in sequence from blaNDM-1. NDM-5, NDM-6 and NDM-7 were identified in two, eight and three isolates, respectively. blaNDM variants were located on plasmids of >100kb with IncF, IncA/C and untypeable replicon types. Genes encoding the 16S rRNA methyltransferases RmtB, RmtC and ArmA as well as those for AmpC β-lactamases were also located on the same plasmids as blaNDM in different combinations. The prevalence of NDM-5 to -7 variants was significantly higher in Escherichia coli (P=0.015) and they were more frequently isolated from the urology ward (P=0.037) than NDM-1. The mortality rate was comparable between patients infected with isolates positive for blaNDM-1 and blaNDM variants [25% (11/44) vs. 23% (3/13)]. Expression of blaNDM variants in E. coli using the same promoter showed that NDM-7 conferred higher resistance to imipenem. The diverse genotypic features of blaNDM indicate rapid evolution of NDM resulting from their wide spread in the Indian subcontinent.

Authors+Show Affiliations

Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, India; Department of Biosciences, Integral University, Lucknow, India.Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, India.Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, India. Electronic address: kashinprasad@gmail.com.Department of Animal Health and VISAVET, Universidad Complutense de Madrid, Madrid, Spain.Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, India.Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, India.Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, India.Department of Biosciences, Integral University, Lucknow, India.Department of Animal Health and VISAVET, Universidad Complutense de Madrid, Madrid, Spain.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24831713

Citation

Rahman, Mohibur, et al. "Prevalence and Molecular Characterisation of New Delhi Metallo-β-lactamases NDM-1, NDM-5, NDM-6 and NDM-7 in Multidrug-resistant Enterobacteriaceae From India." International Journal of Antimicrobial Agents, vol. 44, no. 1, 2014, pp. 30-7.
Rahman M, Shukla SK, Prasad KN, et al. Prevalence and molecular characterisation of New Delhi metallo-β-lactamases NDM-1, NDM-5, NDM-6 and NDM-7 in multidrug-resistant Enterobacteriaceae from India. Int J Antimicrob Agents. 2014;44(1):30-7.
Rahman, M., Shukla, S. K., Prasad, K. N., Ovejero, C. M., Pati, B. K., Tripathi, A., Singh, A., Srivastava, A. K., & Gonzalez-Zorn, B. (2014). Prevalence and molecular characterisation of New Delhi metallo-β-lactamases NDM-1, NDM-5, NDM-6 and NDM-7 in multidrug-resistant Enterobacteriaceae from India. International Journal of Antimicrobial Agents, 44(1), 30-7. https://doi.org/10.1016/j.ijantimicag.2014.03.003
Rahman M, et al. Prevalence and Molecular Characterisation of New Delhi Metallo-β-lactamases NDM-1, NDM-5, NDM-6 and NDM-7 in Multidrug-resistant Enterobacteriaceae From India. Int J Antimicrob Agents. 2014;44(1):30-7. PubMed PMID: 24831713.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and molecular characterisation of New Delhi metallo-β-lactamases NDM-1, NDM-5, NDM-6 and NDM-7 in multidrug-resistant Enterobacteriaceae from India. AU - Rahman,Mohibur, AU - Shukla,Sanket Kumar, AU - Prasad,Kashi Nath, AU - Ovejero,Cristina M, AU - Pati,Binod Kumar, AU - Tripathi,Aparna, AU - Singh,Avinash, AU - Srivastava,Ashwini K, AU - Gonzalez-Zorn,Bruno, Y1 - 2014/04/24/ PY - 2013/09/21/received PY - 2014/03/07/revised PY - 2014/03/07/accepted PY - 2014/5/17/entrez PY - 2014/5/17/pubmed PY - 2015/1/27/medline KW - ESBL KW - Enterobacteriaceae KW - Metallo-β-lactamase KW - Methylase KW - NDM variants KW - NDM-1 SP - 30 EP - 7 JF - International journal of antimicrobial agents JO - Int. J. Antimicrob. Agents VL - 44 IS - 1 N2 - The growing prevalence of carbapenem resistance in Enterobacteriaceae worldwide is a major concern. New Delhi metallo-β-lactamase (NDM)-mediated carbapenem resistance has been identified in Enterobacteriaceae from numerous countries including those of the Indian subcontinent. Currently, seven NDM β-lactamase variants (NDM-1 to -7) have been identified. This study evaluated the detection and molecular characterisation of NDM variants in Enterobacteriaceae at a tertiary care hospital in India. A total of 464 isolates were tested; 57 (12.3%) were resistant or showed reduced susceptibility to imipenem and meropenem. All carbapenem-resistant isolates were blaNDM-positive by PCR, but 13 isolates bore variants that differed in sequence from blaNDM-1. NDM-5, NDM-6 and NDM-7 were identified in two, eight and three isolates, respectively. blaNDM variants were located on plasmids of >100kb with IncF, IncA/C and untypeable replicon types. Genes encoding the 16S rRNA methyltransferases RmtB, RmtC and ArmA as well as those for AmpC β-lactamases were also located on the same plasmids as blaNDM in different combinations. The prevalence of NDM-5 to -7 variants was significantly higher in Escherichia coli (P=0.015) and they were more frequently isolated from the urology ward (P=0.037) than NDM-1. The mortality rate was comparable between patients infected with isolates positive for blaNDM-1 and blaNDM variants [25% (11/44) vs. 23% (3/13)]. Expression of blaNDM variants in E. coli using the same promoter showed that NDM-7 conferred higher resistance to imipenem. The diverse genotypic features of blaNDM indicate rapid evolution of NDM resulting from their wide spread in the Indian subcontinent. SN - 1872-7913 UR - https://www.unboundmedicine.com/medline/citation/24831713/Prevalence_and_molecular_characterisation_of_New_Delhi_metallo_β_lactamases_NDM_1_NDM_5_NDM_6_and_NDM_7_in_multidrug_resistant_Enterobacteriaceae_from_India_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0924-8579(14)00104-6 DB - PRIME DP - Unbound Medicine ER -