Emergence of IncX3 Plasmid-Harboring blaNDM-5 in a Citrobacter sedlakii Isolated from Outdoor Aerosol in Wastewater Treatment Plant

A carbapenem-resistant Citrobacter sedlakii strain AA2CS carrying bla NDM-5 was detected in outdoor aerosols of a wastewater treatment plant (WWTP) in China and the whole genome was sequenced subsequently. AA2CS was captured in an aerobic tank with aerosol particles of sizes ranging from 4.7 to 7.0 μm. Besides bla NDM-5 , AA2CS also harbored 21 other antibiotic resistance genes and displayed a high level of resistance to ampicillin, cefotaxime, ceftazidime, tetracycline, and meropenem. Bla NDM-5 was located on the IncX3 plasmid (pCSNDM-5) with an IS 3000 -IS5- bla NDM-5 - ble MBL - trpF - dsbD -IS 26 structure. pCSNDM-5 was highly homologous to other bla NDM-5 -carrying IncX3 plasmids in China and can be transferred to the Escherichia coli recipient J53. To our knowledge, this is the first report of carbapenem-resistant Enterobacteriaceae in outdoor aerosols in WWTPs.