Multispecies Outbreak of Verona Integron-Encoded Metallo-ß-Lactamase-Producing Multidrug-Resistant Bacteria Driven by a Promiscuous Incompatibility Group A/C2 Plasmid

Abstract

This investigation represents the largest known outbreak of VIM-producing CRE in the United States to date, which comprises numerous bacterial species and strains. We present evidence of in-hospital plasmid transmission, as well as environmental contamination. Our findings demonstrate the potential for 2 types of hospital-acquired infection outbreaks: those due to clonal expansion and those due to the spread of conjugative plasmids encoding antibiotic resistance across species.