A multi-species bunch of VIM-1 Carbapenemase producing enterobacterales linked by a novel, highly conjugative and broad-host range IncA plasmid, menaces the re-emergence of VIM-1

In this study we investigated VIM-1-producing Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Citrobacter freundii, and Enterobacter cloacae strains, isolated in 2019 during a period of active surveillance of carbapenem resistant Enterobacterales in a large university hospital in Italy. VIM-1-producing strains colonized the gut of patients, with up to three different VIM-1-positive bacterial species isolated from a single rectal swab, but also caused bloodstream infection to one colonized patient. In the multi-species cluster the bla VIM-1 was identified in a 5-gene cassette class 1 integron, associated with several genetic determinants, including the bla SHV-12, qnrS1 and mph(A) genes, located on a highly conjugative and broad-host range IncA plasmid. Characteristics and origin of this IncA plasmid were studied.