Genomic similarity of carbapenem-resistant Enterobacterales collected from mothers and their neonates
Objective: New Delhi metallo-β-lactamase is endemic in India and the gut may act as a reservoir of carbapenemase-producing Enterobacterales (CPE). Maternal gut colonisation with blaNDM-harbouring CPE increases the risk of neonatal gut colonisation. This study aimed to assess the vertical transmissio...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-09-01
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| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716525001365 |
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| Summary: | Objective: New Delhi metallo-β-lactamase is endemic in India and the gut may act as a reservoir of carbapenemase-producing Enterobacterales (CPE). Maternal gut colonisation with blaNDM-harbouring CPE increases the risk of neonatal gut colonisation. This study aimed to assess the vertical transmission of CPE from pregnant mothers (rectal) to neonates (rectal and blood). Methods: Rectal samples were collected and processed for the presence of CPE, followed by bacterial identification and antibiotic susceptibility. Mother–neonate pairs colonised with the same species underwent pulsed-field gel electrophoresis and whole-genome sequencing to examine genetic relatedness. Detection of blaNDM variants and their transmissibility was performed. Results: Of the pregnant mothers (n = 86) and sick neonates (n = 93) analysed, eight mother–neonate pairs harboured similar carbapenem-resistant species, predominantly Klebsiella pneumoniae, followed by Escherichia coli. Pulsed-field gel electrophoresis and whole-genome sequencing revealed that most isolates from mother–neonate pairs were distinct and distributed within diverse sequence types, including epidemic clones (ST11/15/147/405/410). blaNDM-1/5/7 were detected in CPE and predominantly associated with conjugative IncFII and IncFII(K) replicons. Genomic analysis supported one case of vertical transmission (ST147; blaNDM-1-positive K. pneumoniae) from mother to a neonate. Further investigation of exogenous sources is required to understand the acquisition of bacteria. No evidence of transmission of blaNDM-harbouring plasmids within mother–neonate pairs carrying distinct isolates was observed, indicating the independent acquisition of bacteria. Conclusions: Although limited evidence of mother-to-neonate transmission was observed in this study, screening of the gut is necessary to understand CPE transmission in hospital settings and beyond. Targeted surveillance and infection-prevention policies are needed to curb CPE spread. |
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| ISSN: | 2213-7165 |