Characterization of Carbapenem-Resistant Enterobacteriaceae Cultured From Retail Meat Products, Patients, and Porcine Excrement in China

Abstract

The emergence and dissemination of carbapenem-resistant Enterobacteriaceae (CRE) is a growing concern to animal and public health. However, little is known about the spread of CRE in food and livestock and its potential transmission to humans. To identify CRE strains from different origins and sources, 53 isolates were cultured from 760 samples including retail meat products, patients, and porcine excrement. Antimicrobial susceptibility testing was carried out, followed by phylogenetic typing, whole-genome sequencing, broth mating assays, and plasmids analyses. Forty-three <i>Escherichia coli</i>, nine <i>Klebsiella pneumoniae</i>, and one <i>Enterobacter cloacae</i> isolates were identified, each exhibiting multidrug-resistant phenotypes. Genetically, the main sequence types (STs) of <i>E. coli</i> were ST156 (<i>n</i> = 7), ST354 (<i>n</i> = 7), and ST48 (<i>n</i> = 7), and the dominant ST of <i>K. pneumoniae</i> is ST11 (<i>n</i> = 5). <i>bla</i> _NDM-5 (<i>n</i> = 40) of <i>E. coli</i> and <i>bla</i> _KPC-2 (<i>n</i> = 5) were the key genes that conferred carbapenem resistance phenotypes in these CRE strains. Additionally, the <i>mcr-1</i> gene was identified in 17 <i>bla</i> _NDM-producing isolates. The <i>bla</i> _NDM-5 gene from eight strains could be transferred to the recipients <i>via</i> conjugation assays. Two <i>mcr-1</i> genes in the <i>E. coli</i> isolates could be co-transferred along with the <i>bla</i> _NDM-5 genes. IncF and IncX3 plasmids have been found to be predominantly associated with <i>bla</i> _NDM gene in these strains. Strains isolated in our study from different sources and regions tend to be concordant and overlap. CRE strains from retail meat products are a reservoir for transition of CRE strains between animals and humans. These data also provide evidence of the dissemination of CRE strains and carbapenem-resistant genes between animal and human sources.