Molecular Characterization of blaNDM-5 Carried on an IncFII Plasmid in an Escherichia coli Isolate from a Nontraveler Patient in Spain

A carbapenem-resistant Escherichia coli isolate (sequence type 448 [ST448]) was recovered from a urine culture of a female pa-tient with no recent record of traveling. PCR screening identified the presence of blaNDM-5, blaTEM-1, blaOXA-1, blaCMY-42, and rmtB. blaNDM-5 was carried in a conjugative IncFII-type plasmid (90 kb) together with blaTEM-1 and rmtB. The genetic environ-ment of blaNDM-5 showed a structure similar to those of pMC-NDM and pGUE-NDM, identified in Poland and France in E. coli of African and Indian origin, respectively. Carbapenemase-producing Enterobacteriaceae (CPE) consti-tute a public health problem regarding both hospital- and community-acquired infections (1). Despite increasing reports of CPE in Europe, predominantly in southern European countries, the prevalence of CPE in Spain still remains relatively low al-though it is steadily increasing, with only a few outbreaks or spo-radic isolates harboring VIM, KPC, OXA-48, or NDM-1 being reported (2). Since the identification of NDM-1 in a Swedish trav-eler returning from India (3), NDMenzymes have received special attention due to their rapid global spread and frequent association with additional resistance genes (4). There are currently 12 NDM variant