Characterization of a blaNDM‑1‑harboring plasmid from a Salmonella enterica clinical isolate in China.

The plasmid-mediated transmission of antibiotic resistance genes has been reported to be involved in the development of antibiotic resistance in bacteria, and poses a serious threat for the success of bacterial infection treatment and human health worldwide. The present study used a 454 GS‑FLX pyrosequencing system to determine the ~140 kb nucleotide sequence of plasmid pHS36‑NDM, which was identified in a Salmonella Stanley isolate from the stool sample of an 11‑month‑old girl at Lishui Central Hospital, China, and which contains a New Delhi metallo‑β‑lactamase‑1 (NDM‑1) carbapenem resistance gene (blaNDM‑1). The 181 open reading frames encode proteins with functions including replication, stable inheritance, antibiotic resistance and mobile genetic elements. Both horizontal transfer and passage stability‑related genes were identified in pHS36‑NDM, including a conserved type 4 secretion system and stbA (stable plasmid inheritance protein A). Two multidrug resistance gene islands were identified: The ISEcp1‑blaCMY transposition unit which contains a CMY‑6 β‑lactamase gene (blaCMY‑6) and a quaternary ammonium compound resistance gene (sugE); and the intI1‑ISCR27 accessory region, which contained a trimethoprim resistance gene (dfrA12), two aminoglycoside resistance genes (aadA2 and rmtC), a truncated quaternary ammonium compound resistance gene (qacE∆1), a sulfonamide resistance gene (sul1), the blaNDM‑1 carbapenemase and a bleomycin resistance gene (bleMBL). pHS36‑NDM shared high homology with other blaNDM‑1‑containing plasmids reported in Sweden, Italy and Japan. However, no previous international travel history was documented for the patient and her family, even to neighboring cities. Furthermore, pHS36‑NDM is of a different incompatibility group to other published blaNDM‑1‑carrying plasmids reported in China, with low homology in the surrounding structure of blaNDM‑1. The present study will facilitate the understanding of the underlying resistance and dispersal mechanism of pHS36‑NDM, and will deepen our recognition of the ongoing spread of the blaNDM‑1‑containing plasmids.