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Two novel NDM-1-encoding plasmids from\n            <jats:named-content content-type=\"genus-species\">Klebsiella pneumoniae<\/jats:named-content>\n            were circularized by PacBio sequencing. In p19-10_01 [IncFIB(K); 223.434 bp],\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>NDM-1<\/jats:sub>\n            was part of a Tn\n            <jats:italic>1548<\/jats:italic>\n            -like structure (16.276 bp) delineated by IS\n            <jats:italic>26<\/jats:italic>\n            . The multireplicon plasmid p18-43_01 [IncR_1\/IncFIB(pB171)\/IncFII(Yp); 212.326 bp] shared an 80-kb region with p19-10_01, not including the\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>NDM-1<\/jats:sub>\n            -containing region. The two plasmids were used as references for tracing NDM-1-encoding plasmids in the other genome assemblies. The p19-10_01 sequence was detected in\n            <jats:named-content content-type=\"genus-species\">K. pneumoniae<\/jats:named-content>\n            (\n            <jats:italic>n<\/jats:italic>\n            = 7) only, whereas p18-43_01 was tracked to\n            <jats:named-content content-type=\"genus-species\">K. pneumoniae<\/jats:named-content>\n            (\n            <jats:italic>n<\/jats:italic>\n            = 4),\n            <jats:named-content content-type=\"genus-species\">Klebsiella michiganensis<\/jats:named-content>\n            (\n            <jats:italic>n<\/jats:italic>\n            = 1),\n            <jats:named-content content-type=\"genus-species\">Serratia marcescens<\/jats:named-content>\n            (\n            <jats:italic>n<\/jats:italic>\n            = 11),\n            <jats:named-content content-type=\"genus-species\">Enterobacter<\/jats:named-content>\n            spp. (\n            <jats:italic>n<\/jats:italic>\n            = 7), and\n            <jats:named-content content-type=\"genus-species\">Citrobacter freundii<\/jats:named-content>\n            (\n            <jats:italic>n<\/jats:italic>\n            = 1), revealing horizontal spread of this\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>NDM-1<\/jats:sub>\n            -bearing plasmid structure. Global phylogeny showed clustering of the\n            <jats:named-content content-type=\"genus-species\">K. pneumoniae<\/jats:named-content>\n            (18\/20) isolates together with closely related carbapenemase-negative ST101 isolates from other geographical origins. The South African isolates were divided into three phylogenetic subbranches, where each group had distinct resistance and replicon profiles, carrying either p19-10_01, p18-10_01, or pCHE-A1 (8,201 bp). The latter plasmid carried\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>GES-5<\/jats:sub>\n            and\n            <jats:italic>aacA4<\/jats:italic>\n            within an integron mobilization unit. Our findings imply independent plasmid acquisition followed by local dissemination. Additionally, we detected\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>OXA-232<\/jats:sub>\n            carried by pPKPN4 in\n            <jats:named-content content-type=\"genus-species\">K. pneumoniae<\/jats:named-content>\n            (ST14) and\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>NDM-5<\/jats:sub>\n            contained by a pNDM-MGR194-like genetic structure in\n            <jats:named-content content-type=\"genus-species\">Escherichia coli<\/jats:named-content>\n            (ST167), adding even more complexity to the multilayer molecular mechanisms behind nosocomial spread of carbapenem-resistant\n            <jats:named-content content-type=\"genus-species\">Enterobacteriaceae<\/jats:named-content>\n            in Durban, South Africa.\n          <\/jats:p>","DOI":"10.1128\/aac.02178-17","type":"journal-article","created":{"date-parts":[[2018,2,28]],"date-time":"2018-02-28T11:11:00Z","timestamp":1519816260000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":77,"title":["Spread of Plasmid-Encoded NDM-1 and GES-5 Carbapenemases among Extensively Drug-Resistant and Pandrug-Resistant Clinical Enterobacteriaceae in Durban, South Africa"],"prefix":"10.1128","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9593-8119","authenticated-orcid":false,"given":"Torunn","family":"Pedersen","sequence":"first","affiliation":[{"name":"Norwegian National Advisory Unit on Detection of Antimicrobial Resistance, Department of Microbiology and Infection Control, University Hospital of North Norway, Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9508-984X","authenticated-orcid":false,"given":"John 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