Here, we presented 11 cases with colistin-resistant Pseudomonas aeruginosa infection and co-existence of OXA-48 and NDM-1 in the ST235 high-risk clone. The molecular analyses were performed by Sanger sequencing and RT-PCR. The eight patients (72.7%) had an invasive infection and three (27.3%) had colonization. The 30-day mortality rate was 87.5% (7/8). Three patients (37.5%, 3/8) received colistin therapy before isolation of P. aeruginosa. In the Multilocus sequence typing (MLST) analysis of 11 isolates, eight (72.7%) isolates belonged to P. aeruginosa ST235 clone. All isolates were NDM-1 positive, and nine isolates (81.8%) were found to be positive for both OXA-48 and NDM-1. Sequences of pmrAB and phoPQ revealed numerous insertions and deletions in all isolates. In 10 isolates pmrAB and phoPQ were found to be upregulated. In conclusion, the co-existence of OXA-48 and NDM-1 genes in colistin-resistant P. aeruginosa ST235 high-risk clone indicates the spread of carbapenemases in clinical isolates and highlights need of continuous surveillance for high-risk clones of P. aeruginosa.

中文翻译：

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OXA-48和NDM-1在大肠杆菌抵抗铜绿假单胞菌ST235中共存。

在这里，我们介绍了11例大肠杆菌抵抗性铜绿假单胞菌感染和OXA-48和NDM-1在ST235高风险克隆中并存。通过Sanger测序和RT-PCR进行分子分析。8例（72.7％）患有浸润性感染，其中3例（27.3％）患有定植。30天死亡率为87.5％（7/8）。三名患者（37.5％，3/8）在分离铜绿假单胞菌之前接受了粘菌素治疗。在11个分离株的多基因座序列分型（MLST）分析中，八个（72.7％）分离株属于铜绿假单胞菌ST235克隆。所有分离株均为NDM-1阳性，发现九种分离株（81.8％）的OXA-48和NDM-1均为阳性。pmrAB和phoPQ序列揭示了所有分离物中的许多插入和缺失。在10个分离物中，发现pmrAB和phoPQ被上调。结论，