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Abstract
Klebsiella pneumoniae strains carrying OXA-48-like carbapenemases are increasingly prevalent across the globe. There is thus an urgent need to better understand the mechanisms that underpin the dissemination of bla OXA-48-like carbapenemases. To this end, four ertapenem-resistant K. pneumoniae isolates producing OXA-48-like carbapenemases were isolated from two patients. Genome sequencing revealed that one sequence type (ST) 17 isolate carried bla OXA-181, whilst three isolates from a single patient, two ST76 and one ST15, carried bla OXA-232. The 50514 bp bla OXA-181-harbouring plasmid, pOXA-181_YML0508, was X3-type with a conjugation frequency to Escherichia coli of 1.94×10−4 transconjugants per donor. The bla OXA-232 gene was located on a 6141 bp ColKP3-type plasmid, pOXA-232_WSD, that was identical in the ST76 and ST15 K. pneumoniae isolates. This plasmid could be transferred from K. pneumoniae to E. coli at low frequency, 8.13×10−6 transconjugants per donor. Comparative analysis revealed that the X3 plasmid acquired the bla OXA-48-like gene via IS3000-mediated co-integration of the ColKP3-type plasmid. Our study highlights how plasmid integration and rearrangements can contribute to the spread of bla OXA-48-like genes, which provides important clues for clinical prevention of the dissemination of K. pneumoniae strains carrying bla OXA-48-like carbapenemases.
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- Accepted:
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Funding
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the Medical Research Council
(Award MR/S013660/1)
- Principle Award Recipient: Willemvan Schaik
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the National Science and Technology Major Project
(Award 2018ZX10714002)
- Principle Award Recipient: PingShen
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the Key Research and Development Programme of Zhejiang
(Award 2015C03046)
- Principle Award Recipient: YunsongYu
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the National Natural Science Foundation of China
(Award 81802043)
- Principle Award Recipient: DongdongZhao
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the National Natural Science Foundation of China
(Award 81830069)
- Principle Award Recipient: YunsongYu