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Volume 24, Number 8—August 2018
Research

Novel Enterobacter Lineage as Leading Cause of Nosocomial Outbreak Involving Carbapenemase-Producing Strains

Racha Beyrouthy, Marion Barets, Elodie Marion, Cédric Dananché, Olivier Dauwalder, Frédéric Robin, Lauraine Gauthier, Agnès Jousset, Laurent Dortet, François Guérin, Thomas Bénet, Pierre Cassier, Philippe Vanhems1, and Richard Bonnet1Comments to Author 
Author affiliations: Centre Hospitalier Universitaire, Clermont-Ferrand, France (R. Beyrouthy, F. Robin, R. Bonnet); Centre National de Référence de la Résistance aux Antibiotiques, Clermont-Ferrand (R. Beyrouthy, F. Robin, R. Bonnet); Université Clermont Auvergne, Clermont-Ferrand (R. Beyrouthy, F. Robin, R. Bonnet); Institut National de la Santé et de la Recherche Médicale, Clermont-Ferrand (R. Beyrouthy, F. Robin, R. Bonnet); Institut National de la Recherche Agronomique, Clermont-Ferrand (R. Beyrouthy, F. Robin, R. Bonnet); Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France (M. Barets, E. Marion, C. Dananché, T. Bénet, P. Cassier, P. Vanhems); Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon (O. Dauwalder); Centre International de Recherche en Infectiologie, Lyon (O. Dauwalder, T. Bénet, P. Vanhems),; Centre Hospitalier Universitaire Bicêtre, Paris, France (L. Gauthier, A. Jousset, L. Dortet); Centre National de Référence Associé de la Résistance aux Antibiotiques, Paris (L. Gauthier, A. Jousset, L. Dortet); Centre Hospitalier Universitaire, Caen, France (F. Guérin)

Main Article

Figure 4

Analysis of blaVIM-4–encoding plasmids from study of nosocomial outbreak involving carbapenamase-producing Enterobacter strains, Lyon, France, January 12, 2014–December 31, 2015. A) Schematic representation of ST1-IncHI2 plasmid pC45-VIM4. The first ring indicates the coordinates of the complete plasmid circle. The 2 outer rings represent the forward and the reverse open reading frames, respectively. B) Comparative sequence analysis of ST1-IncHI2 blaVIM-4–encoding plasmids from this study. The p

Figure 4. Analysis of blaVIM-4–encoding plasmids from study of nosocomial outbreak involving carbapenamase-producing Enterobacter strains, Lyon, France, January 12, 2014–December 31, 2015. A) Schematic representation of ST1-IncHI2 plasmid pC45-VIM4. The first ring indicates the coordinates of the complete plasmid circle. The 2 outer rings represent the forward and reverse open reading frames, respectively. B) Comparative sequence analysis of ST1-IncHI2 blaVIM-4–encoding plasmids from this study. The plasmids of isolates C45, C46, C47, C48, C308, C309, C310, E14, and E16 are designated pC45-VIM4, pC46-VIM4, pC47-VIM4, pC48-VIM4, pC308-VIM4, pC310-VIM4, pE14-VIM4, pE16-VIM4, and pC309-VIM4, respectively. C) Comparative sequence analysis of blaVIM-4–encoding plasmid pC45-VIM4 to the related blaVIM-1–encoding IncHI2 plasmids pMRVIM0813 (GenBank accession no. KP975077), pRH-R27 (GenBank accession no. LN555650), and pRH-R178 (GenBank accession no. HG530658). Vertical blocks between sequences indicate regions of shared similarity shaded according to blastn (https://blast.ncbi.nlm.nih.gov/Blast.cgi). Blue indicates matches in the same direction; red indicates inverted matches.

Main Article

1These authors contributed equally to this article.

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