Infection of Diabetes Foot Caused by Carbapenem-Resistant Proteus penneri Mediated by a Novel Plasmid Containing bla_NDM

Figures & data

Table 1 The Characteristics of Patient

	Patient
Gender	Male
Age	68
Department	Hand and foot surgery
Diagnosis	Gangrene of diabetic foot
Specimen types	Purulence
Report date	7/17/2016

Figure 1 Integrated view of the medical record.

Notes: The date marked by arrow was the date of isolation of the P. penneri strains.

Abbreviations: CZO, Cefazolin; LVX, Levofloxacin.

Table 2 Outcomes of Antimicrobial Susceptibility Testing, Predicted Resistance Genes and Plasmid Type of CR-PPE

	Phenotype
Antimicrobial susceptibility testing
Antimicrobials
MIC
CRO	16(R)
AMK	≥64(R)
GEN	≥16(R)
AMP	≥32(R)
ATM	<=1(S)
CAZ	≥64(R)
CIP	≥4(R)
LVX	4(R)
FEP	8(R)
SXT	≥16(R)
TOB	8(R)
CTT	<=4(S)
TZP	8(S)
SAM	≥32(R)
ETP	2(R)
PIP	18(R)
KB
MEM	20(I)
CXM	6(R)
CZO	6(R)
CSL	14(R)
FOX	6(R)
IPM	16(R)
Predicted resistance genes and plasmid type	Genotype
Resistance genes	tet(B), sul2, APH(4)-Ia, AAC(3)-IV, mphE, msrE, blaNDM-1, bleMBL, floR, APH(3’)-VI, arr-3, catB3, blaOXA-1, AAC(6’)-Ib-cr, sul1, dfrA12, linG, aadA2
Plasmid type	Col3M_1

Abbreviations: MIC, minimum inhibitory concentration; KB, Kirby–Bauer.

Figure 2 Plasmid map of the plasmid pWF127-NDM harboring bla_NDM-1.

Figure 3 Genetic environment of bla_NDM-1. Adapted from Wang P, Jiang X, Mu K, et al. DANMEL: a manually curated reference database for analyzing mobile genetic elements associated with bacterial drug resistance. mLife. 2022; 1: 460-64. © 2022 The Authors. mLife published by John Wiley & Sons Australia, Ltd. on behalf of Institute of Microbiology, Chinese Academy of Sciences.²⁰

Figure 4 Evolutionary tree of 10 strains of Proteus penneri.

Wang P, Jiang X, Mu K, et al. DANMEL: a manually curated reference database for analyzing mobile genetic elements associated with bacterial drug resistance. mLife. 2022; 1: 460–464. doi: 10.1002/mlf2.12046

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