Outbreak of Multidrug Resistant NDM-1-Producing Klebsiella pneumoniae from a Neonatal Unit in Shandong Province, China. Yan Jin,.BrowseSubjectAreas?ClickthroughthePLOStaxonomytofindarticlesinyourfield.FormoreinformationaboutPLOSSubjectAreas,clickhere.ArticleAuthorsMetricsCommentsMediaCoverageReaderComments(0)FiguresFiguresAbstractDespiteworldwidedisseminationofNewDelhimetallo-β-lactamase1(blaNDM-1),outbreaksremainuncommoninChina.Inthisstudy,wedescribethecharacteristicsoftheoutbreak-relatedblaNDM-1-producingK.pneumoniaisolatesinaneonatalunitinShandongprovince,China.Werecovered21non-repetitivecarbapenem-resistantK.pneumoniaeisolateswithapositivelymodifiedHodgetest(MHT)orEDTAsynergistictestfrompatientsandenvironmentalsamplesinShandongprovincialhospital.Pulsed-fieldgelelectrophoresis(PFGE)andmultilocussequencetyping(MLST)datashowK.pneumoniaeisolatesfrom19patientswereclonallyrelatedandbelongtotheclonalgroupsST20andST17.Wenotetwooutbreaks,thefirstcausedbyST20duringAugust2012involvingfourpatients,andthesecondcausedbyST20andST17duringJanuary2012andSeptember2013involvingfourteenpatients.Wefoundthebedrailingofonepatientwasthesourceoftheoutbreak.WeverifiedthepresenceoftheblaNDM-1genein21K.pneumoniaeisolates.ThegenesblaCTX-M-15,blaCTX-M-14,blaDHA-1,blaTEM-1andClassIintegronwerealsopresentin18(85.7%),3(14.3%),18(85.7%),19(90.5%)and19(90.5%)isolates,respectively.WealsofoundanisolatewithbothblaNDM-1andblaIMP-4.Alloftheisolatesexhibitedamultidrug-resistancephenotype.Theβ-lactamresistanceof20isolateswastransferableviaconjugation.Inaddition,weshowtheresistanceof21K.pneumoniaeisolatestocarbapenemisnotrelatedtolackofouter-membraneproteinsOmpK35andOmpK36noroverpressionofeffluxpumps.ThisstudyprovidesthefirstreportconfirmingblaNDM-1-producingK.pneumoniaeST20andST17wereassociatedwithoutbreak.Earlydetectionofresistancegenesisaneffectivestrategyinpreventingandcontrollinginfectionbylimitingthedisseminationoftheseorganisms.Citation:JinY,ShaoC,LiJ,FanH,BaiY,WangY(2015)OutbreakofMultidrugResista