New Delhi Metallo-β-Lactamase Plasmidomes of Intensive Care Unit Clinical and Environmental Enterobacterales Isolates.

Authors

Florencia Martino, Denise De Belder, Renata Monge, Agustina Forastiero, Molly Patrick, Kara A Moser, Alejandra Corso, Fernando Pasteran, Matthew Robinson, Valeria Fabre

Published in

Open forum infectious diseases. Volume 13. Issue 10. Pages ofag663. Epub Oct 07, 2026.

Abstract

There are limited data on the molecular epidemiology of New Delhi metallo-β-lactamase (NDM)-producing carbapenem-resistant Enterobacterales (CRE) in Latin America, despite the high burden of NDM-CRE in the region. This study characterized bla _NDM-harboring plasmids from CRE from patients and the environment of an Argentine hospital.
We performed whole-genome sequencing of 40 environmental isolates (Klebsiella complex, n = 11; Enterobacter cloacae, complex n = 16; Citrobacter freundii, n = 10; Serratia marcescens, n = 3) and 4 clinical isolates (Klebsiella pneumoniae, n = 4) recovered from the environment and rectal surveillance samples of patients in the same intensive care units (ICUs) at a tertiary care center in Argentina, July 2023-February 2024, respectively. Representative genomic groups underwent Oxford Nanopore sequencing and hybrid genome assembly for complete plasmid characterization. Resolved bla _NDM-harboring plasmids were compared across species and publicly available reference sequences to characterize plasmid relatedness and dissemination patterns.
Ten representative genomic groups were identified across species, including 7 defined sequence types and 3 assigned in this study. bla _NDM-1 and bla _NDM-5 were present in 72.5% (29/40) and 27.5% (11/40) of environmental isolates, respectively (all 4 clinical isolates were bla _NDM-5). Hybrid assembly of the representative genomic groups revealed bla _NDM-1 was located on highly conserved plasmids belonging to the IncC incompatibility group across multiple CRE species. bla _NDM-5 was restricted to Klebsiella spp. and was associated with structurally diverse plasmids including IncF- and IncHI1B/IncFIB-type backbones in both environmental and patient isolates.
These findings highlight the ICU environment as a reservoir for bla _NDM plasmids.

PMID:
42898562
Bibliographic data and abstract were imported from PubMed on 20 Oct 2026.

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