Occurrence of NDM-1, VIM-1, and OXA-10 Co-Producing Clinical Isolate in China

is a nosocomial pathogen associated with urinary tract infections related to hospital-acquired Infections. In recent years, clinical strains producing New Delhi Metallo-β-lactamase (NDM) and other β-lactamase which reduce the efficiency of antimicrobial therapy have been reported. However, there are few reports of co-producing two metallo-β-lactamases in one isolate. Here, we first reported a strain (P138) co-harboring , , and . The specie were identified using MALDI-TOF MS. The results of antimicrobial susceptibility testing by broth microdilution method indicated that P138 was resistant to meropenem (MIC = 64μg/ml), imipenem (MIC = 64μg/ml), and aztreonam (MIC = 32μg/ml). Conjugation experiments revealed that the -carrying plasmid was transferrable. The carbapenemase genes were detected using PCR and confirmed by PCR-based sequencing. The complete genomic sequence of the was identified using Illumina (Illumina, San Diego, CA, USA) short-read sequencing (150bp paired-end reads), and many common resistance genes had been identified, including , , , , , , and . The gene was characterized by the following structure: IS-TnpA-IntI1-aadB-IS-GroEL-GroES-DsbD-PAI-ble--IS-QnrS1-IS. Blast comparison revealed that the gene structure shared >99% similarity with plasmid p5_SCLZS62 (99% nucleotide identity and query coverage). In summary, we isolated a strain coproducing , , and blaOXA-10. To the best of our acknowledge, this was first reported in the world. The occurrence of the strain needs to be closely monitored.