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Abstract

Carbapenems are last-resort antibiotics for treatment of infections caused by multidrug-resistant , but carbapenem resistance is a rising global threat due to the acquisition of carbapenemase genes. Oxacillinase-48 ( )-type carbapenemases are increasing in abundance in Canada and elsewhere; these genes are frequently found on mobile genetic elements and are associated with specific transposons. This means that alongside clonal dissemination, genes can spread through plasmid-mediated horizontal gene transfer. We applied whole genome sequencing to characterize 249 -producing isolates collected by the Canadian Nosocomial Infection Surveillance Program from 2010 to 2021. Using a combination of short- and long-read sequencing, we obtained 70 complete and circular -encoding plasmids. Using MOB-suite, four major plasmids clustered were identified, and we further estimated a plasmid cluster for 91.9 % (147/160) of incomplete -encoding contigs. We identified different patterns of carbapenemase mobilization across Canada, including horizontal transmission of /IncX3 plasmids (75/249, 30.1 %) and /IncL/M plasmids (47/249, 18.9 %), and both horizontal transmission and clonal transmission of for ST231 on ColE2-type/ColKP3 plasmids (25/249, 10.0 %). Our findings highlight the diversity of OXA-48-type plasmids and indicate that multiple plasmid clusters and clonal transmission have contributed to spread and persistence in Canada.

Funding
This study was supported by the:
  • Public Health Agency of Canada
    • Principle Award Recipient: NotApplicable
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution.
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2024-06-19
2024-07-15
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