Characterization of NDM-7 Carbapenemase-Producing Escherichia coli Isolates in the Arabian Peninsula.
AIM
The purpose of this study was to characterize the New Delhi metallo-beta lactamase (NDM)-7-producing Enterobacteriaceae isolated in the Arabian Peninsula.


METHODS
Enterobacteriaceae identified to carry blaNDM-7 in a collection of 157 NDM-producing isolates from Kuwait, Oman, Saudi Arabia, and the United Arab Emirates (UAE) were investigated for their antibiotic and disinfectant susceptibility, and resistance gene content. The virulence profile, phylogenetic and sequence types of the isolates were also determined. The plasmids carrying the blaNDM-7 were transferred, and their complete nucleotide sequence was determined.


RESULTS
Four NDM-7-producing Escherichia coli isolated in Kuwait, Oman, and the UAE, respectively, were identified. They were clonally unrelated, carried a few virulence determinants only, and belonged to clonal complexes CC10 and CC23, or ST448. They were all multi-drug resistant but remained susceptible to fosfomycin, tigecycline, and colistin. In all isolates, blaNDM-7 was located on IncX3 type plasmids of a variable size, not harboring any further resistance genes. The plasmids exhibited a high degree of similarity to each other and to pKpN01-NDM7 from Canada, with various size deletions and insertions.


CONCLUSIONS
Our findings show that IncX3 type plasmids play an important role in the spread of the currently rare NDM-7 variant in the Arabian Peninsula. This association of blaNDM-7 with the IncX3-type plasmid is particularly worrisome, as this type of plasmid was proved to spread other carbapenemases in various species of Enterobacteriaceae worldwide at a high efficiency.
['Pál|Tibor|T|', 'Ghazawi|Akela|A|', 'Darwish|Dania|D|', 'Villa|Laura|L|', 'Carattoli|Alessandra|A|', 'Hashmey|Rayhan|R|', 'Aldeesi|Zulfa|Z|', 'Jamal|Wafaa|W|', 'Rotimi|Vincent|V|', 'Al-Jardani|Amina|A|', 'Al-Abri|Seif S|SS|', 'Sonnevend|Ágnes|Á|']
D000900:Anti-Bacterial Agents D015780:Carbapenems D002999:Clone Cells D003091:Colistin D024901:Drug Resistance, Multiple, Bacterial D004926:Escherichia coli D004927:Escherichia coli Infections D005578:Fosfomycin D015870:Gene Expression D006801:Humans D007730:Kuwait D008826:Microbial Sensitivity Tests D008911:Minocycline D058885:Multilocus Sequence Typing D009850:Oman D010802:Phylogeny D010957:Plasmids D012529:Saudi Arabia D000078304:Tigecycline D014479:United Arab Emirates D001618:beta-Lactamases
NDM-7 Escherichia coli multi-drug resistance carbapenemase Middle East