NDM-1-producing Enterobacteriaceae in a teaching hospital in Shanghai, China: IncX3-type plasmids may contribute to the dissemination of blaNDM-1

• This is the first report of NDM-1-positive Enterobacteriaceae from Shanghai, China.
• We provide the genetic characteristics of blaNDM-1 in Shanghai, China.
• IncX3 plasmids, reported in various species in the United Arab Emirates and China, may contribute to the dissemination of blaNDM-1.
• More attention should be devoted to control the dissemination of the NDM-1 gene due to its potential horizontal transfer via mobile genetic elements.

SummaryObjectivesTo provide the epidemiological dissemination and the genetic characteristics of blaNDM-1 in a teaching hospital in Shanghai, China.MethodsHere, the carbapenemase genes of 114 CRE isolates were evaluated by polymerase chain reaction (PCR). Clonal relatedness was assessed by pulsed-field gel electrophoresis (PFGE). Conjugation experiments and Southern blot hybridization were performed to determine the transferability of plasmids. Then plasmids were completely sequenced by the shotgun method.ResultsTwo Klebsiella pneumoniae strains (RJA1227 and RJF866) and one Raoultella planticola strain (RJA274) were identified as NDM-1 positive. The two K. pneumoniae isolates belonged to ST11 and exhibited highly similar PFGE patterns. Shotgun sequencing showed that plasmid pRJF866 (ca. 110 kb) contained genes associated with the IncFII-FIB group and was highly similar to plasmid pKOX_NDM1. RJA274 (ca. 50 kb) harbored blaNDM-1 on an IncX3 plasmid, which was nearly identical to plasmid pNDM-HN380 except that part of the ISAba125 element is missing.ConclusionThis is the first report of NDM-1-positive Enterobacteriaceae from Shanghai, China. IncX3 plasmids, reported in various species in the United Arab Emirates and China, may contribute to the dissemination of blaNDM-1.. More attention should be devoted to monitoring the dissemination of the NDM-1 gene due to its potential horizontal transfer via mobile genetic elements.