Genomic Epidemiology of Global Carbapenemase-Producing Enterobacter spp., 2008-2014

• Published in: Emerging infectious diseases Vol. 24; no. 6; pp. 1010 - 1019
• Main Authors: Peirano, Gisele, Matsumura, Yasufumi, Adams, Mark D, Bradford, Patricia, Motyl, Mary, Chen, Liang, Kreiswirth, Barry N, Pitout, Johann D D
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.06.2018; Centers for Disease Control and Prevention
• Subjects: Anti-Bacterial Agents - pharmacology; antimicrobial resistance; bacteria; Bacterial Proteins - biosynthesis; Bacterial Proteins - genetics; beta-Lactamases - biosynthesis; beta-Lactamases - genetics; carbapenemases; Drug Resistance, Bacterial; Enterobacter - classification; Enterobacter - drug effects; Enterobacter - genetics; Enterobacter spp; Enterobacteriaceae; Enterobacteriaceae Infections - epidemiology; Enterobacteriaceae Infections - history; Enterobacteriaceae Infections - microbiology; Genetic aspects; Genome, Bacterial; genomic epidemiology; Genomic Epidemiology of Global Carbapenemase-Producing; Genomics - methods; Genotypes; Global Health; Health aspects; History, 21st Century; Humans; Microbial drug resistance; Microbial Sensitivity Tests; Molecular Epidemiology; Phylogeny; Plasmids - genetics; Polymorphism, Single Nucleotide; Population Surveillance; spp., 2008–2014; surveillance; bacteria; genomic epidemiology; antimicrobial resistance; Enterobacter spp; surveillance; carbapenemases; Enterobacteriaceae
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid2406.171648

We performed whole-genome sequencing on 170 clinical carbapenemase-producing Enterobacter spp. isolates collected globally during 2008-2014. The most common carbapenemase was VIM, followed by New Delhi metallo-β-lactamase (NDM), Klebsiella pneumoniae carbapenemase, oxacillin 48, and IMP. The isolates were of predominantly 2 species (E. xiangfangensis and E. hormaechei subsp. steigerwaltii) and 4 global clones (sequence type [ST] 114, ST93, ST90, and ST78) with different clades within ST114 and ST90. Particular genetic structures surrounding carbapenemase genes were circulating locally in various institutions within the same or between different STs in Greece, Guatemala, Italy, Spain, Serbia, and Vietnam. We found a common NDM genetic structure (NDM-GE-U.S.), previously described on pNDM-U.S. from Klebsiella pneumoniae ATCC BAA-214, in 14 different clones obtained from 6 countries spanning 4 continents. Our study highlights the importance of surveillance programs using whole-genome sequencing in providing insight into the molecular epidemiology of carbapenemase-producing Enterobacter spp.