FIG 6.
Three different patterns of dissemination of blaNDM-harboring plasmid. (A) Clonal expansion of E. coli carrying IncFII-type plasmid harboring blaNDM was observed in the same hematology ward. Closely related isolates were also found in environmental samples. (B) Diverse clinical and environmental isolates possessed IncX3-type plasmids harboring blaNDM-4 or blaNDM-7, suggesting dissemination of the plasmids via horizontal plasmid transfer (dotted arrows). (C) Closely related K. pneumoniae or Enterobacter xiangfangensis carrying blaNDM-1-harboring plasmids were isolated in different wards in the hospital, suggesting clonal expansion among the different wards (arrows). *, the types of blaNDM-1-harboring plasmids are IncFIB(pQil) and IncFII(pRSB107) for K. pneumoniae and E. xiangfangensis, respectively.