Carbapenemase-producing Pseudomonas aeruginosa (CPPA) is a threat to public health. This study aimed to describe the first emergence and molecular characterization of NDM-1-producing P. aeruginosa in South Korea. A total of 183 carbapenem-resistant P. aeruginosa (CRPA) isolates were recovered from patients at a university hospital in Seoul, South Korea. The antimicrobial resistance genes and their genetic environments were determined through molecular sequencing. Antimicrobial susceptibility testing was performed using the VITEK 2 system and broth microdilution method. Genetic relatedness was assessed using multilocus sequence typing and pulsed-field gel electrophoresis. Whole genome sequencing (WGS) was carried out to analyze the entire genome of a CPPA isolated from the index patient; the first identified infected patient. All 16 CPPA isolates from the 183 CRPA carried the bla_NDM-1 gene and exhibited a high level of resistance to β-lactams, aminoglycosides, and ciprofloxacin. Fifteen of the 16 isolates were recovered from urine samples. They were attributed to ST773 and showed high clonal similarity (>86%). Post-WGS analysis revealed that the bla_NDM-1 gene and the 16S rRNA methyltransferase gene rmtB4 were located in the integrative and conjugative element (ICE) on the chromosome. This ICE6660-like region was very similar to the ICE6660 region carrying the bla_NDM-1 gene and the 16S rRNA methyltransferase gene rmtD3 in a previously described P. aeruginosa strain. This study described the first emergence and clonal spread of the NDM-1-producing P. aeruginosa ST773 isolates possessing rmtB4, at a university hospital in South Korea, suggesting that continuous surveillance is necessary to prevent infection and transmission of these CRPAs, which can endanger public health.

中文翻译：

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韩国第一个产生 NDM-1 的铜绿假单胞菌分离株的分子表征

产碳青霉烯酶的铜绿假单胞菌(CPPA) 对公众健康构成威胁。本研究旨在描述韩国产 NDM-1铜绿假单胞菌的首次出现和分子特征。共183株耐碳青霉烯铜绿假单胞菌(CRPA) 分离株是从韩国首尔大学医院的患者身上回收的。通过分子测序确定抗菌素耐药基因及其遗传环境。使用 VITEK 2 系统和肉汤微量稀释方法进行抗菌药敏试验。使用多位点序列分型和脉冲场凝胶电泳评估遗传相关性。进行全基因组测序 (WGS) 以分析从索引患者中分离出的 CPPA 的整个基因组；第一个确定的感染患者。来自 183 种 CRPA 的所有 16 种 CPPA 分离株都携带bla _NDM-1基因并对β-内酰胺类、氨基糖苷类和环丙沙星表现出高度耐药性。从尿样中回收了 16 株分离株中的 15 株。它们归因于 ST773 并显示出高克隆相似性 (>86%)。WGS 后分析显示bla _NDM-1基因和 16S rRNA 甲基转移酶基因rmtB4位于染色体上的整合和接合元件 (ICE) 中。该 ICE 6660 样区域与先前描述的铜绿假单胞菌中携带bla _NDM-1基因和 16S rRNA 甲基转移酶基因rmtD3的 ICE 6660区域非常相似拉紧。这项研究说明的第一出现和NDM-1产生的克隆传播铜绿假单胞菌ST773拥有株rmtB4，在韩国一所大学医院，这表明连续的监督是必要的，以防止感染和这些CRPAs的传输，这会危及公共卫生。