Abstract:
This study describes 3 different blaNDM-1 genetic platforms in 3 different species obtained from
the same patient who was directly transferred to an institution in Calgary, Canada, following a
prolonged hospital stay in India. The blaNDM-1 in the Escherichia coli was located on a 176kb
IncA/C plasmid contained within an ISCR1 region. The blaNDM-1 in the Providencia rettgeri was
located on a 117kb IncT plasmid contained within Tn3000, while the blaNDM-1 in Pseudomonas
aeruginosa was located on the chromosome within an ISCR3 region. This report highlights the
plasticity of the genetic regions and environments associated with blaNDM-1. To the best of our
knowledge, this is the first report of P. aeruginosa with blaNDM-1 identified in North America and
the first report of blaOXA-181in P. rettgeri. The P. aeruginosa belonged to the international high
risk clone ST654 and was non-susceptible to colistin. This case emphasizes the need for
appropriate infection prevention and control measures and vigilant screening for carbapenem
resistant Gram negative bacteria in patients with a history of travel to endemic areas, such as the
Indian subcontinent.
