New Delhi metallo-β-lactamase (NDM) had been reported to be the predominant carbapenemase among Escherichia coli in Taiwan.SkiptomaincontentThankyouforvisitingnature.com.YouareusingabrowserversionwithlimitedsupportforCSS.Toobtainthebestexperience,werecommendyouuseamoreuptodatebrowser(orturnoffcompatibilitymodeinInternetExplorer).Inthemeantime,toensurecontinuedsupport,wearedisplayingthesitewithoutstylesandJavaScript.AdvertisementnaturescientificreportsarticlesarticleIncreasingNewDelhimetallo-β-lactamase-positiveEscherichiacoliamongcarbapenemnon-susceptibleEnterobacteriaceaeinTaiwanduring2016to2018DownloadPDFSubjectsBacteriaClinicalmicrobiologyInfectiousdiseasesMicrobialgeneticsAbstractNewDelhimetallo-β-lactamase(NDM)hadbeenreportedtobethepredominantcarbapenemaseamongEscherichiacoliinTaiwan.However,studiesfocusingontheclonalbackgroundandepidemiologyofplasmidscarryingNDMgeneswerelimited.Between2016and2018,allclinicalE.coliandKlebsiellapneumoniaeisolatesthatwerenon-susceptibletoertapenem,meropenem,andimipenemweretestedforcarbapenemase-encodinggenes(CEGs)andantimicrobialsusceptibilities.Moleculartypingwasperformedonallcarbapenemase-producingisolates.Wholegenomesequencing(WGS)wasperformedonallNDM-positiveE.coliisolates.Twenty-three(29.5%)of78carbapenemnon-susceptibleE.coliand108(35.3%)of306carbapenemnon-susceptibleK.pneumoniaeisolatescarriedCEGs.ThemostprevalentCEGsincarbapenemase-producingE.coli(CPEc)wereblaNDM(39.1%)andblaIMP-8(30.4%),whilethatincarbapenemase-producingK.pneumoniaewasKlebsiellapneumoniaecarbapenemase(KPC)(72.2%).Fifteensequencetypeswereidentifiedamong23CPEc,and55.6%ofNDM-positiveE.coliisolatesbelongedtoST410.WGSshowedST410isolateswerehighlyclonalandsimilartothosefromothercountries.AllNDM-5-positiveE.coliisolatescarriedidenticalIncX3plasmidharboringblaNDM-5butnootherantimicrobialresistance(AMR)genes.IneachofthefourNDM-1-positiveE.coliisolates,theblaNDM-1waspresentina∼300kbIncHI2/IncHI2AplasmidwhichcarriedanarrayofAMRgenes.NDMsarethemostprevalentcarbapenem