Characterisation of the CTX-M-15-encoding gene in Klebsiella pneumoniae strains from the Barcelona metropolitan area: plasmid diversity and chromosomal integration

fWe report complete genome sequences of four bla NDM-1 -harboring Gram-negative multidrug-resistant (MDR) isolates from Colombia. The bla NDM-1 genes were located on 193-kb Inc FIA, 178-kb Inc A/C2, and 47-kb (unknown Inc type) plasmids. Multilocus sequence typing (MLST) revealed that these isolates belong to sequence type 10 (ST10) (Escherichia coli), ST392 (Klebsiella pneumoniae), and ST322 and ST464 (Acinetobacter baumannii and Acinetobacter nosocomialis, respectively). Our analysis identified that the Inc A/C2 plasmid in E. coli contained a novel complex transposon (Tn125 and Tn5393 with three copies of bla NDM-1 ) and a recombination "hot spot" for the acquisition of new resistance determinants.A t this time, bla NDM is recognized as a major global health threat. Guatemala and Colombia reported the first cases of bla NDM-1 -harboring isolates in Latin America (1, 2). In both instances, bla NDM-1 was discovered in hospital-acquired, clonally related Klebsiella pneumoniae isolates that were recovered from patients who had not travelled recently. The molecular epidemiology of bla NDM carbapenemases in South America has been investigated only in a limited fashion, and data in Colombia are very scarce. In order to understand the dissemination of bla NDM-1 in Colombia, we performed a genomic analysis of four sentinel isolates, Acinetobacter baumannii, Acinetobacter nosocomialis, Escherichia coli, and K. pneumoniae collected in 2012, shortly after the first reported outbreak (1).

supporting

confidence: 57%

Initial Assessment of the Molecular Epidemiology of bla _NDM-1 in Colombia

Rojas

Wright

Cadena

et al. 2016

“…A lthough the spread of CTX-M-15 has mainly been associated with a high-risk clone of Escherichia coli sequence type 131 (ST131), Klebsiella pneumoniae isolates that produce CTX-M-15 are also disseminated worldwide (1,2). In particular, the K. pneumoniae ST11 clone has been reported to be the most predominant CTX-M-15-producing clone in many countries, including South Korea (3)(4)(5).…”

mentioning

confidence: 99%

A Plasmid Bearing the bla _CTX-M-15 Gene and Phage P1-Like Sequences from a Sequence Type 11 Klebsiella pneumoniae Isolate

Shin

2015

Plasmid pKP12226 was extracted and analyzed from a CTX-M-15-producing Klebsiella pneumoniae sequence type 11 (ST11) isolate collected in South Korea. The plasmid represents chimeric characteristics consisting of a pIP1206-like backbone and lysogenized phage P1-like sequences. It bears a resistance region that includes resistance genes to several antibiotics and is different from previously characterized plasmids from South Korea bearing bla CTX-M-15 . It may have resulted from recombination between an Escherichia coli plasmid backbone, a bla CTX-M-15 -bearing resistance region, and lysogenized phage P1-like sequences.A lthough the spread of CTX-M-15 has mainly been associated with a high-risk clone of Escherichia coli sequence type 131 (ST131), Klebsiella pneumoniae isolates that produce CTX-M-15 are also disseminated worldwide (1, 2). In particular, the K. pneumoniae ST11 clone has been reported to be the most predominant CTX-M-15-producing clone in many countries, including South Korea (3-5). Similar to E. coli ST131, it has been observed that bla CTX-M-15 is usually located on IncF-type plasmids in K. pneumoniae isolates that produce CTX-M-15. Our previous studies have shown somewhat contradictory results on the evolution of the plasmid bearing bla CTX-M-15 in K. pneumoniae: while replicon typing of IncFII-type plasmids indicated that bla CTX-M-15 might not have been transferred directly from E. coli to K. pneumoniae, whole-plasmid analysis showed that bla CTX-M-15 -bearing plasmids from three different K. pneumoniae clones might result from recombination between a common plasmid backbone in K. pneumoniae and the resistance regions from plasmids of E. coli ST131 (6, 7). However, previous studies did not analyze the plasmids of CTX-M-15-producing K. pneumoniae ST11, a disseminating clone present worldwide, including in South Korea.In the present study, we determined the complete sequence of a plasmid carrying bla CTX-M-15 from a South Korean K. pneumoniae ST11 isolate, because the IncF-type plasmid of ST11 is the most prevalent in South Korea. We identified that the backbone of the plasmid is very similar to a plasmid of E. coli, and phage-like sequences were identified.pKP12226 is a plasmid carrying bla CTX-M-15 from K. pneumoniae strain K01-12226 isolated from a patient with bacteremia in South Korea. The isolate was determined to produce CTX-M-15-type extended-spectrum ␤-lactamases (ESBLs) and was found in our previous study (2) to belong to ST11. Conjugation of the plasmid carrying the bla CTX-M-15 gene was accomplished by using E. coli strain J53 as a recipient, which is sodium azide resistant and plasmid free, as shown in previous studies (7,8). A Roche 454 genome sequencer FLX system (version 2.6) was used for wholeplasmid sequencing of plasmid pKP12226. A total of 51,656 sequence reads were generated, yielding a mean sequence coverage of 15ϫ. The sequencing reads were assembled into consensus de novo assembly contigs using the Roche 454 genome sequencer FLX software GSA assembler (version 2.6), yieldin...

“…CTX-M-15, which was first identified in 2001 from patients hospitalized in India (15), is the most common CTX-M variant worldwide, possessing significant activity against ceftazidime (16). The bla CTX-M-15 gene is mostly located on large plasmids of various types and sizes, but it may also be identified on the chromosome of K. pneumoniae (17). The acquisition of both chromosomally encoded and plasmid-carried bla CTX-M-15 genes has been shown to be related to the association with insertion sequence ISEcp1 (18).…”

Section: N Osocomial Infections Caused By Multidrug-resistant (Mdr)mentioning

confidence: 99%

Acquisition of Broad-Spectrum Cephalosporin Resistance Leading to Colistin Resistance in Klebsiella pneumoniae

Jayol

Nordmann

Desroches

et al. 2016

An extended-spectrum ␤-lactamase (ESBL)-producing and colistin-resistant Klebsiella pneumoniae clinical isolate was recovered from a patient who was treated with cefotaxime. This isolate harbored a bla CTX-M-15 ESBL gene that was associated with an ISEcp1 insertion sequence. Transposition of that tandem occurred within the chromosomal mgrB gene, leading to inactivation of the mgrB gene and consequently to acquired resistance to colistin. We showed here a coselection of colistin resistance as a result of a broad-spectrum cephalosporin selective pressure.