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Antimicrobial susceptibility and carbapenemase production were performed in 31 isolates, including one from an unopened bottle of TPN. Carbapenemase-encoding genes, extended-spectrum \u03b2-lactamase\u2013encoding genes were screened by PCR, and plasmid profiles were determined. Horizontal transfer of carbapenem resistance was performed by solid mating. Clonal diversity was performed by pulsed-field gel electrophoresis. The resistome was explored by whole-genome sequencing on two selected strains, and comparative genomics was performed using Roary.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>All 31 isolates were resistant to aztreonam, cephalosporins, carbapenems, trimethoprim\/sulfamethoxazole, and susceptible to gentamicin, tetracycline, and colistin. Lower susceptibility to levofloxacin (51.6%) and ciprofloxacin (22.6%) was observed. All the isolates were carbapenemase producers and positive for <jats:italic>bla<\/jats:italic><jats:sub>NDM-1<\/jats:sub>, <jats:italic>bla<\/jats:italic><jats:sub>TEM-1B<\/jats:sub>, and <jats:italic>bla<\/jats:italic><jats:sub>SHV-12<\/jats:sub> genes. One main lineage was detected (clone A, 83.9%; A1, 12.9%; A2, 3.2%). The <jats:italic>bla<\/jats:italic><jats:sub>NDM-1<\/jats:sub> gene is embedded in a Tn<jats:italic>125<\/jats:italic>-like element.<\/jats:p>\n                <jats:p>Genome analysis showed genes encoding resistance for aminoglycosides<jats:italic>,<\/jats:italic> quinolones<jats:italic>,<\/jats:italic> trimethoprim, colistin<jats:italic>,<\/jats:italic> phenicols, and sulphonamides and the presence of IncFII (Yp), IncHI2, and IncHI2A incompatibility groups. Comparative genomics showed a major phylogenetic relationship among <jats:italic>L. adecarboxylata<\/jats:italic> I1 and USDA-ARS-USMARC-60222 genomes, followed by our two selected strains.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>We present epidemiological, microbiological, and molecular evidence of an outbreak of carbapenem-resistant <jats:italic>L. adecarboxylata<\/jats:italic> in three hospitals in western Mexico associated with the use of contaminated TPN.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-05923-0","type":"journal-article","created":{"date-parts":[[2021,2,28]],"date-time":"2021-02-28T04:34:49Z","timestamp":1614486889000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Molecular investigation of an outbreak associated with total parenteral nutrition contaminated with NDM-producing Leclercia adecarboxylata"],"prefix":"10.1186","volume":"21","author":[{"given":"Elvira","family":"Garza-Gonz\u00e1lez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Bocanegra-Ibarias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Rodr\u00edguez-Noriega","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban","family":"Gonz\u00e1lez-D\u00edaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Silva-Sanchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulises","family":"Garza-Ramos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iv\u00e1n Fernando","family":"Contreras-Coronado-Tovar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Ecil","family":"Santos-Hern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Guti\u00e9rrez-Ba\u00f1uelos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Pablo","family":"Mena-Ramirez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sa\u00fal","family":"Ram\u00edrez-De-los-Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adri\u00e1n","family":"Camacho-Ortiz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9576-1950","authenticated-orcid":false,"given":"Rayo","family":"Morf\u00edn-Otero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,28]]},"reference":[{"issue":"2","key":"5923_CR1","doi-asserted-by":"publisher","first-page":"95","DOI":"10.4103\/0019-5049.63637","volume":"54","author":"KV Chowdary","year":"2010","unstructured":"Chowdary KV, Reddy PN. 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