First case of NDM-1 producing Klebsiella pneumoniae in Caribbean islands

Abstract

Objectives: Characterize a NDM-1 producing K. pneumoniae isolate recovered from a patient hospitalized in Guadeloupe, French West Indies, after its transfer from Cuba. Methods: Antibiotic susceptibilities were determined by the disk diffusion method, and E-test. Carbapenemase production was assessed using the Carba NP test. Antibiotic resistance determinants and their surrounding structures were characterized by PCR mapping and DNA sequencing. Transfer of the β-lactam resistance marker was attempted by liquid mating-out assays. Results: Here we reported the first NDM-1 producing enterobacterial isolate recovered from Caribbean islands. This K. pneumoniae isolate belongs to a new sequence type (ST1649). The blaNDM-1 gene together with the aacA4 gene were carried on a self conjugative IncR plasmid of c.a. 80kb. Conclusion: This study describes the first identification of a NDM-1 producer in Caribbean islands. The uncommon incompatibility group of the blaNDM-1 carrying plasmid and the uncommon ST type of the K. pneumoniae strain suggest a possible local emergence of NDM producers.