First Identification of blaNDM-1 in High-Risk Klebsiella pneumoniae ST147 Clone in Cameroon: A Genomic Insight
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Background The emergence and spread of carbapenemase-producing Klebsiella pneumoniae (CP-Kp) represent a serious clinical challenge due to limited treatment options. This pilot study aimed to track the evidence of CP-Kp genes in Yaounde, Cameroon where antimicrobial resistance (AMR) surveillance data remain scarce. Methods The resistance profile of clinical Klebsiella pneumoniae isolated in Yaoundé, Cameroon was investigated using routine Antibiotic Susceptibility Testing (AST) and Whole Genome Sequencing (WGS). Carbapenemase production was phenotypically confirmed using the selective chromogenic medium designed for the detection of carbapenemase-producing Enterobacterales (CHROMagar™ Modified SuperCARBA™), and the Klebsiella pneumoniae carbapenemase (KPC)/Metallo-β-lactamase (MBL)/Oxacillinase-48 (OXA-48) confirmatory kit. Results Three carbapenemase-producing Klebsiella pneumoniae strains, isolated from urine and lower limb wounds were found to belong to the high-risk sequence type ST147 and harbored the bla NDM −1 carbapenemase gene on an IncHI1B (pNDM-MAR) plasmid. Whole Genome Sequencing concurrently detected additional β-lactamase genes bla CTX-M − 15 , bla DHA −1 , bla OXA −1 , bla TEM −1 , bla SHV −67 and other resistance genes conferring resistance to aminoglycosides, phenicols, fosfomycin, macrolides, quinolones, sulphonamides, and tetracyclines. Plasmid analysis identified three plasmids, one (10,634 bp) which carried aadA1 and dfrA15 genes. Phylogenetic analysis revealed a high degree of sequence similarity among the three isolates, with a SNP distance of only 2, suggesting a recent clonal dissemination. Conclusions These findings represent the first report of the bla NDM −1 gene in Cameroon, identified in the high-risk clone K. pneumoniae ST147. A large-scale epidemiological investigation is warranted to determine the prevalence of this clone and to establish robust antimicrobial stewardship strategies to contain these multidrug-resistant pathogens.
