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. 2021 Dec 14;10(12):1527.
doi: 10.3390/antibiotics10121527.

The Spread of NDM-1 and NDM-7-Producing Klebsiella pneumoniae Is Driven by Multiclonal Expansion of High-Risk Clones in Healthcare Institutions in the State of Pará, Brazilian Amazon Region

Yan Corrêa Rodrigues  1 , Amália Raiana Fonseca Lobato  1 , Ana Judith Pires Garcia Quaresma  1 , Lívia Maria Guimarães Dutra Guerra  1 , Danielle Murici Brasiliense  1
Affiliations

The Spread of NDM-1 and NDM-7-Producing Klebsiella pneumoniae Is Driven by Multiclonal Expansion of High-Risk Clones in Healthcare Institutions in the State of Pará, Brazilian Amazon Region

Yan Corrêa Rodrigues et al. Antibiotics (Basel). .

Abstract

Carbapenem resistance among Klebsiella pneumoniae isolates is often related to carbapenemase genes, located in genetic transmissible elements, particularly the blaKPC gene, which variants are spread in several countries. Recently, reports of K. pneumoniae isolates harboring the blaNDM gene have increased dramatically along with the dissemination of epidemic high-risk clones (HRCs). In the present study, we report the multiclonal spread of New Delhi metallo-beta-lactamase (NDM)-producing K. pneumoniae in different healthcare institutions in the state of Pará, Northern Brazil. A total of 23 NDM-producing isolates were tested regarding antimicrobial susceptibility testing features, screening of carbapenemase genes, and genotyping by multilocus sequencing typing (MLST). All K. pneumoniae isolates were determined as multidrug-resistant (MDR), being mainly resistant to carbapenems, cephalosporins, and fluoroquinolones. The blaNDM-7 (60.9%-14/23) and blaNDM-1 (34.8%-8/23) variants were detected. MLST genotyping revealed the predomination of HRCs, including ST11/CC258, ST340/CC258, ST15/CC15, ST392/CC147, among others. To conclude, the present study reveals the contribution of HRCs and non-HRCs in the spread of NDM-1 and NDM-7-producing K. pneumoniae isolates in Northern (Amazon region) Brazil, along with the first detection of NDM-7 variant in Latin America and Brazil, highlighting the need for surveillance and control of strains that may negatively impact healthcare and antimicrobial resistance.

Keywords: CC15; CC258; Gram-negative bacteria; Klebsiella pneumoniae; ST392; antimicrobial resistance; carbapenemase; molecular epidemiology; multi-drug resistance.

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Conflict of interest statement

The authors declare no conflict of interest regarding the publication of the present study.

Figures

Figure 1
Figure 1
Minimum spanning tree (MST) of the 23 NDM-producing K. pneumoniae isolates genotyped by MLST. Each circle represents a different ST, and the size of the circle is proportional to the number of isolates related to the respective ST. The number next to the lines represents the number of loci variations between STs.
See this image and copyright information in PMC

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