Kaiying Wang,1,2,* Peihan Li,1,2,* Jinhui Li,2,* Xiaofeng Hu,2,* Yanfeng Lin,1,2 Lang Yang,1,2 Shaofu Qiu,2 Hui Ma,*,3 Peng Li,2 Hongbin Song2 1College of Military Medicine, Academy of Military Sciences, Beijing, People's Republic of China; 2Center for Disease Control and Prevention of PLA, Beijing, People's Republic of China; 3The Sixth Medical Center of PLA General Hospital, Beijing, People's Republic of China*These authors contributed equally to this workCorrespondence: Peng Li; Hongbin Song

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... Tel/ Fax +86-10-66948475Email jiekenlee@126.com; hongbinsong@263.netBackground: The New Delhi metallo-β-lactamase-1 (NDM-1)-positive plasmid and its variants pose daunting threats to public health. Hospital sewage was considered as an important reservoir of antibiotic genes. Numerous and diverse taxa of multidrug-resistant (MDR) bacteria carrying NDM-1-positive plasmids have been identified during routine surveillance of hospital sewage. We herein report a carbapenem-resistant Acinetobacter towneri strain AeBJ009 with an NDM-1-positive plasmid isolated from hospital sewage.Materials and Methods: Bacteria were isolated from cultures of hospital sewage and identified by using the Vitek 2 compact system and 16S rRNA sequencing. The blaNDM-1 gene was amplified and confirmed by sequencing. Antimicrobial susceptibility testing was performed using AST-GN14 on the Vitek2 compact system. In addition, the blaNDM-1 gene was located by Southern blotting. Conjugation experiment and whole-genome sequencing were performed for further analysis.Results: Strain AeBJ009 was isolated from hospital sewage and identified as A. towneri. Antimicrobial susceptibility testing revealed an MDR phenotype. Pulsed-field gel electrophoresis and Southern blotting showed that strain AeBJ009 carries three plasmids and that blaNDM-1 is located on the 47kb plasmid pNDM-AeBJ009. However, the conjugation experiment to transfer pNDM-AeBJ009 to Escherichia coli strain J53 was unsuccessful. Whole-genome sequencing found that pNDM-AeBJ009 contains a Tn 125 element [...]