New Delhi Metallo-β-Lactamase–producing Enterobacteriaceae, United States

摘要

We characterized 9 New Delhi metallo-β-lactamase–producing Enterobacteriaceae (5 Klebsiella pneumoniae, 2 Escherichia coli, 1 Enterobacter cloacae, 1 Salmonella enterica serovar Senftenberg) isolates identified in the United States and cultured from 8 patients in 5 states during April 2009–March 2011. Isolates were resistant to β-lactams, fluoroquinolones, and aminoglycosides, demonstrated MICs ≤1 μg/mL of colistin and polymyxin, and yielded positive metallo-β-lactamase screening results. Eight isolates had bla_NDM-1, and 1 isolate had a novel allele (bla_NDM-6). All 8 patients had recently been in India or Pakistan, where 6 received inpatient health care. Plasmids carrying bla_NDM frequently carried AmpC or extended spectrum β-lactamase genes. Two K. pneumoniae isolates and a K. pneumoniae isolate from Sweden shared incompatibility group A/C plasmids with indistinguishable restriction patterns and a common bla_NDM fragment; all 3 were multilocus sequence type 14. Restriction profiles of the remaining New Delhi metallo-β-lactamase plasmids, including 2 from the same patient, were diverse.