NDM-1-producing Enterobacteriaceae from South Africa: moving towards endemicity?

We describe 4 patients infected with NDM-1 Enterobacter cloacae, Citrobacter freundii, and Serratia riiarcescens from South Africa that co-produced SHV-12, CTX-M-3, and CTX-M-15 and were positive for qnrS, qnrA, aac(6')-Ib-cr, rmtF, rmtC, and armA. Plasmids belonged to IncN, IncA/C replicon types with ccdAB and vagC/D addiction factors. Local and imported cases of NDM-producing bacteria co-exist within South Africa. (C) 2014 Elsevier Inc. All rights reserved.