Application of Next-Generation Sequencing in PublicHealth--Analysis of NDM-5-Carrying Bacteria, 2014-2017

Application of Next-Generation Sequencing in PublicHealth--Analysis of NDM-5-Carrying Bacteria, 2014-2017

Next-Generation Sequencing(NGS) hasthe advantage of high throughput sequence capacity which provides information on unlimited pathogen targets, resistance genes, as well as outbreak surveillance. In this study, we applied NGS for epidemiological surveillance on the bacterial antimicrobial resistance. From 2014 to 2017, 8carbapenem-resistant Enterobacteriaceae（CRE）isolates carrying NDM-5 were identified andoriginated from 2 hospitalsin northernTaiwan (HH and TH) and 1 from a hospital in southernTaiwan (CH), respectively.Among them, 5 isolates from HH hospitalhad high similarity in PFGE phylogenetic analysis, similarplasmid replicon type and size and identical NDM-5-containing contigs. Taken together, these 5 isolates wereconsidered as epidemiologically related strains. Two isolates from TH hospital hadlower similarity in PFGE phylogenetic analysis, differencesin plasmid types and size. However, the NDM-5-containing contigswere identical, presumably due to the insertion sequence IS26 which is responsible to transmission of theantimicrobial-resistancegenes. As of the isolate from CH hospital, the sequence of its NDM-5-containingplasmid was similar tothe internationallyepidemic NDM-5plasmid, indicating that the plasmid might be imported.This study shares the vision on the use of NGS to provide the CRE antimicrobial-resistance information and benefit the epidemiological surveillance in the future. We recommended that CRE in Taiwan should be monitor continuously to follow the distribution and trends of antimicrobial resistant bacteria.