Genetic Plurality of OXA/NDM-Encoding Features Characterized From Enterobacterales Recovered From Czech Hospitals

Abstract

The aim of this study was to characterize four <i>Enterobacterales</i> co-producing NDM- and OXA-48-like carbapenemases from Czech patients with travel history or/and previous hospitalization abroad. <i>Klebsiella pneumoniae</i> isolates belonged to "high risk" clones ST147, ST11, and ST15, while the <i>Escherichia coli</i> isolate was assigned to ST167. All isolates expressed resistance against most β-lactams, including carbapenems, while retaining susceptibility to colistin. Furthermore, analysis of WGS data showed that all four isolates co-produced OXA-48- and NDM-type carbapenemases, in different combinations (Kpn47733: <i>bla</i> _NDM- ₅ + <i>bla</i> _OXA- ₁₈₁; Kpn50595: <i>bla</i> _NDM- ₁ + <i>bla</i> _OXA- ₁₈₁; Kpn51015: <i>bla</i> _NDM- ₁ + <i>bla</i> _OXA- ₂₄₄; Eco52418: <i>bla</i> _NDM- ₅ + <i>bla</i> _OXA- ₂₄₄). In Kpn51015, the <i>bla</i> _OXA- ₂₄₄ was found on plasmid p51015_OXA-244, while the respective gene was localized in the chromosomal contig of <i>E. coli</i> Eco52418. On the other hand, <i>bla</i> _OXA- ₁₈₁ was identified on a ColKP3 plasmid in isolate Kpn47733, while a <i>bla</i> _OXA- ₁₈₁-carrying plasmid being an IncX3-ColKP3 fusion was identified in Kpn50595. The <i>bla</i> _NDM- ₁ gene was found on two different plasmids, p51015_NDM-1 belonging to a novel IncH plasmid group and p51015_NDM-1 being an IncF _<i>K</i> ₁-FIB replicon. Furthermore, the <i>bla</i> _NDM- ₅ was found in two IncFII plasmids exhibiting limited nucleotide similarity to each other. In both plasmids, the genetic environment of <i>bla</i> _NDM- ₅ was identical. Finally, in all four carbapenemase-producing isolates, a diverse number of additional replicons, some of these associated with important resistance determinants, like <i>bla</i> _CTX-M- ₁₅, <i>arr-2</i> and <i>ermB</i>, were identified. In conclusion, this study reports the first description of OXA-244-producing <i>Enterobacterales</i> isolated from Czech hospitals. Additionally, our findings indicated the genetic plurality involved in the acquisition and dissemination of determinants encoding OXA/NDM carbapenemases.