Genomic similarity of carbapenem-resistant Enterobacterales collected from mothers and their neonates.

Basak, Priyanka, Naha, Sharmi, Sands, Kirsty, Dutta, Subhajit, Mukherjee, Suchandra, Saha, Bijan, Walsh, Timothy R. ORCID: https://orcid.org/0000-0003-4315-4096 and Basu, Sulagna 2025. Genomic similarity of carbapenem-resistant Enterobacterales collected from mothers and their neonates. Journal of Global Antimicrobial resistance 10.1016/j.jgar.2025.06.004

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Abstract

New Delhi metallo-β-lactamase, is endemic in India, and the gut may act as a reservoir of carbapenemase-producing Enterobacterales (CPEs). Maternal gut colonization with bla -harbouring CPE increases the risk of neonatal gut colonization. This study aimed to assess the vertical transmission of CPE from pregnant mother (rectal) to neonate (rectal and blood). Rectal samples were collected and processed for the presence of CPEs, followed by bacterial identification and antibiotic susceptibility. Mother-neonate pairs colonized with the same species underwent pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS) to examine genetic relatedness. Detection of bla -variants and their transmissibility was performed. Of the pregnant mothers (n=86) and sick neonates (n=93) analyzed, eight mother-neonate pairs harbored similar carbapenem-resistant species, predominantly Klebsiella pneumoniae, followed by Escherichia coli. PFGE and WGS revealed that most isolates from mother-neonate pairs were distinct and distributed within diverse sequence types, including epidemic clones (ST11/15/147/405/410). bla were detected in CPE and were predominantly associated with conjugative IncFII and IncFII(K) replicons. Genomic analysis supported one case of vertical transmission (ST147; bla +ve-K. pneumoniae) from mother to a neonate. Further investigation of exogenous sources is required to understand the acquisition of bacteria. No evidence of transmission of bla -harboring plasmids within mother-neonate pairs carrying distinct isolates was observed, indicating independent acquisition of bacteria. Although limited evidence of mother-to-neonate transmission had been observed in this study, screening of the gut is necessary to understand CPE transmission in hospital settings and beyond it. Targeted surveillance and infection prevention policies are needed to curb CPE spread. [Abstract copyright: Copyright © 2025. Published by Elsevier Ltd.]

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Medicine
Date of Acceptance:	4 June 2025
Last Modified:	03 Jul 2025 16:00
URI:	https://orca.cardiff.ac.uk/id/eprint/179529

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