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Abstract

Background

Since 2021, an emergence of New Delhi metallo-β-lactamase (NDM)-14-producing has been identified in France. This variant with increased carbapenemase activity was not previously detected in Enterobacterales.

Aim

We investigated the rapid dissemination of NDM-14 producers among patients in hospitals in France.

Methods

All NDM-14-producing non-duplicate clinical isolates identified in France until June 2022 (n = 37) were analysed by whole genome sequencing. The phylogeny of NDM-14-producers among all sequence type (ST) 147 reported in France since 2014 (n = 431) was performed. Antimicrobial susceptibility testing, conjugation experiments, clonal relationship and molecular clock analysis were performed.

Results

The 37 NDM-14 producers recovered in France until 2022 belonged to ST147. The dissemination of NDM-14-producing was linked to a single clone, likely imported from Morocco and responsible for several outbreaks in France. The gene was harboured on a 54 kilobase non-conjugative IncFIB plasmid that shared high homology with a known -carrying plasmid. Using Bayesian analysis, we estimated that the NDM-14-producing ST147 clone appeared in 2020. The evolutionary rate of this clone was estimated to 5.61 single nucleotide polymorphisms per genome per year. The NDM-14 producers were highly resistant to all antimicrobials tested except to colistin, cefiderocol (minimum inhibitory concentration 2 mg/L) and the combination of aztreonam/avibactam.

Conclusion

Highly resistant NDM-14 producing can rapidly spread in healthcare settings. Surveillance and thorough investigations of hospital outbreaks are critical to evaluate and limit the dissemination of this clone.

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/content/10.2807/1560-7917.ES.2023.28.42.2300095
2023-10-19
2024-02-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2023.28.42.2300095
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