A series of clinical NDM-5-producing Escherichia coli isolates obtained from two surveillance networks for carbapenem-producing Enterobacterales from 2018 to 2019, namely, Switzerland (NARA) and Germany (SurvCARE), were analyzed. The 33 NDM-5-producing E. coli isolates were highly resistant to β-lactams, including novel β-lactam/β-lactamase inhibitor combinations (ceftazidime-avibactam, imipenem-relebactam, and meropenem-vaborbactam), and remained susceptible to fosfomycin, colistin, and tigecycline. These isolates were assigned to different sequence types (STs) and indicated a predominance of isolates exhibiting ST167 in Switzerland and Germany (n = 10) (phylogenetic group C), followed by ST405 (n = 4) (phylogenetic group E), ST1284 (n = 4) (phylogenetic group C), and ST361 (n = 4) (phylogenetic group C). The bla_NDM-5 gene was predominantly present on an IncF-type plasmid (n = 29) and, to a lesser extent, on the narrow-host-range IncX3 plasmid (n = 4). Sequence analyses of eight NDM-5 plasmids indicated that NDM-5-encoding F-type plasmids varied in size between 86 and 132 kb. The two IncX3 plasmids pCH8NDM5 and pD12NDM5 were 46 and 45 kb in size, respectively. The highly conserved bla_NDM-5 genetic surrounding structures (ΔISAba125-bla_NDM-5-ble_MBL-trpT-dsbD-IS26) of both the F-type and IncX3 plasmids suggested a common genetic origin. The emergence of the NDM-5 carbapenemase was evidenced in particular for the E. coli ST167 clone, which is a successful epidemic clone known to be associated with both multiresistance and virulence traits and is therefore of high public health concern. The occurrence of clonally related NDM-5-producing E. coli isolates in Switzerland and Germany further indicates the international spread of this multidrug-resistant superbug at least throughout Europe.

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瑞士和德国生产碳青霉烯酶NDM-5的大肠杆菌跨境出现

分析了从 2018 年至 2019 年瑞士 (NARA) 和德国 (SurvCARE)两个产碳青霉烯肠杆菌监测网络获得的一系列临床产 NDM-5大肠杆菌分离株。33株产生 NDM-5 的大肠杆菌分离株对 β-内酰胺类药物具有高度耐药性，包括新型 β-内酰胺/β-内酰胺酶抑制剂组合（头孢他啶-阿维巴坦、亚胺培南-瑞巴坦和美罗培南-vaborbactam），并且仍然对磷霉素敏感、粘菌素和替加环素。这些分离株被分配到不同的序列类型 (STs) 并表明在瑞士和德国 ( n = 10) (系统发育组 C) 中表现出 ST167 的分离株占优势，其次是 ST405 ( n= 4)（系统发育组 E）、ST1284（n = 4）（系统发育组 C）和 ST361（n = 4）（系统发育组 C）。所述BLA _NDM-5基因是主要存在上INCF型质粒（Ñ = 29），并且在较小程度上，在窄宿主范围IncX3质粒（Ñ = 4）。八个 NDM-5 质粒的序列分析表明 NDM-5 编码 F 型质粒的大小在 86 和 132 kb 之间变化。两个 IncX3 质粒 pCH8NDM5 和 pD12NDM5 的大小分别为 46 和 45 kb。高度保守的bla _NDM-5遗传周围结构（ΔIS Aba125-bla _NDM-5 - ble _MBL - trpT-dsbDF-型和 IncX3 质粒的-IS 26 ) 表明了共同的遗传起源。NDM-5 碳青霉烯酶的出现特别证明了大肠杆菌ST167 克隆，这是一种成功的流行性克隆，已知与多抗性和毒力特征相关，因此引起高度的公共卫生关注。在瑞士和德国出现的产生 NDM-5 的克隆性大肠杆菌分离株进一步表明这种多重耐药超级细菌至少在整个欧洲在国际上传播。