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

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ID: 331886
2026
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Abstract
Abstract Background 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 blaNDM-harboring plasmids from CRE from patients and the environment of an Argentine hospital. Methods We performed whole-genome sequencing of 40 environmental (Klebsiella complex, n = 11, Enterobacter cloacae complex n = 16, Citrobacter freundii, n = 10, Serratia marcescens, n = 3), and four clinical isolates (Klebsiella pneumoniae, n=4) recovered from intensive care unit (ICU) patients (rectal-surveillance samples) and the environment, in a tertiary care center in Argentina, July 2023-February 2024. Representative genomic groups underwent Oxford Nanopore sequencing and hybrid genome assembly for complete plasmid characterization. Resolved blaNDM-harboring plasmids were compared across species and publicly available reference sequences to characterize plasmid relatedness and dissemination patterns. Results Ten representative genomic groups were identified across species, including seven defined sequence types (STs) and three assigned in this study. blaNDM-1 and blaNDM-5 were present in 72.5% (29/40) and 27.5% (11/40) of environmental isolates, respectively (all four clinical isolates were blaNDM-5). Hybrid assembly of the representative genomic groups revealed blaNDM-1 was located on highly conserved plasmids belonging to the IncC incompatibility group across multiple CRE species. blaNDM-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. Conclusions These findings highlight the ICU environment as a reservoir for blaNDM plasmids.
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Authors Florencia Martino, Denise De Belder, Renata Monge, Agustina Forastiero, Molly Patrick, Kara A. Moser, Alejandra C. Corso, Fernando G. Pasterán, Matthew L. Robinson, Valeria Fabre
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Journal Open forum infectious diseases
Year 2026
DOI
10.1093/ofid/ofag663
URL
https://doi.org/10.1093/ofid/ofag663
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