Molecular Epidemiology of OXA-48 and NDM-1 Producing Enterobacterales Species at a University Hospital in Tehran, Iran, Between 2015 and 2016
Journal article, 2020

Carbapenem-resistant Enterobacterales (CRE) is an increasing problem worldwide. Here, we examined the clonal relatedness of 71 non-repetitive CRE isolates collected in a university hospital in Tehran, Iran, between February 2015 and March 2016. Pulsed-field gel electrophoresis (PFGE) and MLST were used for epidemiological analysis. Screening for antibiotic resistance genes, PCR-based replicon typing, conjugation experiments, and optical DNA mapping were also performed. Among all 71 isolates, 47 isolates of Klebsiella pneumoniae (66.2%), eight Escherichia coli (11.2%), five Serratia marcescens (7%), and two Enterobacter cloacae (2.8%) harbored blaNDM–1 and blaOXA–48 genes together or alone. PFGE analysis revealed that most of the OXA-48- and NDM-1-producing K. pneumoniae and all of OXA-48-producing S. marcescens were clonally related, while all eight E. coli and two E. cloacae isolates were clonally unrelated. The predominant clones of carbapenemase-producing K. pneumoniae associated with outbreaks within the hospital were ST147 (n = 13) and ST893 (n = 10). Plasmids carrying blaNDM–1 and blaOXA–48 were successfully transferred to an E. coli K12-recipient strain. The blaOXA–48 gene was located on an IncL/M conjugative plasmid, while the blaNDM–1 gene was located on both IncFII ∼86-kb to ∼140-kb and IncA/C conjugative plasmids. Our findings provide novel epidemiologic data on carbapenemase-producing Enterobacterales (CPE) in Iran and highlight the importance of horizontal gene transfer in the dissemination of blaNDM–1 and blaOXA–48 genes. The occurrence and transmission of distinct K. pneumoniae clones call for improved infection control to prevent further spread of these pathogens in Iran.


carbapenemase-producing Enterobacterales



optical DNA mapping


Hamid Solgi

Isfahan University of Medical Sciences

Shoeib Nematzadeh

Karolinska University Hospital

Christian G. Giske

Karolinska University Hospital

Farzad Badmasti

Pasteur Institute of Iran

Fredrik Westerlund

Chalmers, Biology and Biological Engineering, Chemical Biology

Yii Lih Lin

Chalmers, Biology and Biological Engineering, Chemical Biology

Gaurav Goyal

Chalmers, Biology and Biological Engineering, Chemical Biology

Vajihe Sadat Nikbin

Pasteur Institute of Iran

Amir Hesam Nemati

Pasteur Institute of Iran

Fereshteh Shahcheraghi

Pasteur Institute of Iran

Frontiers in Microbiology

1664-302X (ISSN)

Vol. 11 936

Subject Categories

Infectious Medicine


Microbiology in the medical area



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8/3/2020 4