NDM-producing Enterobacteriaceae in Poland, 2012–14: inter-regional outbreak of Klebsiella pneumoniae ST11 and sporadic cases

摘要: Objectives The objective of this study was to characterize New Delhi metallo-β-lactamase (NDM)-producing Enterobacteriaceae isolates reported in Poland 2012-14. Methods Representative were typed by PFGE and MLST. NDM other β-lactamase genes amplified sequenced. Plasmids with blaNDM analysed nuclease S1 plus hybridization profiling, transfer assays PCR-based replicon typing. genetic context studied PCR mapping assays. Results Of 374 cases infection/colonization NDM-positive identified 2012-14, 370 40 hospitals, 10 outpatient clinics 1 nursing home associated a Klebsiella pneumoniae outbreak epicentres Poznan Warsaw. strain K. ST11 similar an isolate from the Czech Republic 2013. Like strain, many had two blaNDM-1-carrying IncFII- IncR-type plasmids variable size, sharing blaNDM-1-containing segment. early also produced CTX-M-15 co-encoded plasmids, differentiated later extensive plasmid rearrangements. Four 2013, three being arrivals Montenegro, India or Afghanistan. Indian Escherichia coli ST448 NDM-5 revealed similarity recent Spain, including observed previously E. strains France (of Congolese origins, respectively). Afghani Proteus mirabilis second species chromosomal blaNDM-1 location. Conclusions largest non-endemic country has been observed, alarming phenomenon resistance epidemiology Poland.