Characterization of a Conjugative Hybrid Plasmid Coharboring
 bla
 KPC-2
 and
 bla
 IMP-4
 in a Klebsiella quasipneumoniae Clinical Isolate

Dong, Huiyue; Liu, Ziyi; Wu, Zhiyao; Zhang, Tingting; Xia, Ziwei; Zhao, Yuxin; Li, Yan; Shi, Jinjin; Wang, Zhiqiang; Li, Ruichao; Qin, Shangshang

doi:10.1128/spectrum.02616-22

Cited by 4 publications

(1 citation statement)

References 21 publications

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“…A database search revealed four strains carrying two major carbapenemase genes and localized to the same plasmid. A genetic feature description of a clinically derived strain carrying bla KPC−2 and bla IMP−4 was also reported by Dong et al [ 37 ]. This suggests the great potential of fusion plasmids in the integration of resistance genes and the need to be alert to the spread and prevalence of fusion plasmids in the clinical setting.…”

Section: Discussionmentioning

confidence: 61%

Difference analysis and characteristics of incompatibility group plasmid replicons in gram-negative bacteria with different antimicrobial phenotypes in Henan, China

Chen,

Li,

et al. 2024

BMC Microbiol

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Background Multi-drug-resistant organisms (MDROs) in gram-negative bacteria have caused a global epidemic, especially the bacterial resistance to carbapenem agents. Plasmid is the common vehicle for carrying antimicrobial resistance genes (ARGs), and the transmission of plasmids is also one of the important reasons for the emergence of MDROs. Different incompatibility group plasmid replicons are highly correlated with the acquisition, dissemination, and evolution of resistance genes. Based on this, the study aims to identify relevant characteristics of various plasmids and provide a theoretical foundation for clinical anti-infection treatment. Methods 330 gram-negative strains with different antimicrobial phenotypes from a tertiary hospital in Henan Province were included in this study to clarify the difference in incompatibility group plasmid replicons. Additionally, we combined the information from the PLSDB database to elaborate on the potential association between different plasmid replicons and ARGs. The VITEK mass spectrometer was used for species identification, and the VITEK-compact 2 automatic microbial system was used for the antimicrobial susceptibility test (AST). PCR-based replicon typing (PBRT) detected the plasmid profiles, and thirty-three different plasmid replicons were determined. All the carbapenem-resistant organisms (CROs) were tested for the carbapenemase genes. Results 21 plasmid replicon types were detected in this experiment, with the highest prevalence of IncFII, IncFIB, IncR, and IncFIA. Notably, the detection rate of IncX3 plasmids in CROs is higher, which is different in strains with other antimicrobial phenotypes. The number of plasmid replicons they carried increased with the strain resistance increase. Enterobacterales took a higher number of plasmid replicons than other gram-negative bacteria. The same strain tends to have more than one plasmid replicon type. IncF-type plasmids tend to be associated with MDROs. Combined with PLSDB database analysis, IncFII and IncX3 are critical platforms for taking blaKPC−2 and blaNDM. Conclusions MDROs tend to carry more complex plasmid replicons compared with non-MDROs. The plasmid replicons that are predominantly prevalent and associated with ARGs differ in various species. The wide distribution of IncF-type plasmids and their close association with MDROs should deserve our attention. Further investigation into the critical role of plasmids in the carriage, evolution, and transmission of ARGs is needed.

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Section: Discussionmentioning

confidence: 61%

Difference analysis and characteristics of incompatibility group plasmid replicons in gram-negative bacteria with different antimicrobial phenotypes in Henan, China

Chen,

Li,

et al. 2024

BMC Microbiol

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Genomic insight into the distribution and genetic environment of blaIMP-4 in clinical carbapenem-resistant Klebsiella pneumoniae strains in China

Zheng

Liu

et al. 2023

Microbiological Research

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Double bla _KPC-2 copies quadrupled minimum inhibitory concentration of ceftazidime–avibactam in hospital-derived Klebsiella pneumoniae

Hu,

Wang,

et al. 2024

Microbiol Spectr

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To illustrate the genomic and drug resistance traits of the Klebsiella pneumoniae Kpn_XM9, which harbors a transposon (Tn) As1 and was barely susceptible to ceftazidime–avibactam (CZA). Whole-genome sequencing, gene deletion, antimicrobial susceptibility, and conjugation tests were carried out to illustrate the traits of Kpn_XM9. As confirmed by whole-genome sequencing, the Kpn_XM9 harbored a 5,523,536 bp chromosome and five plasmids with lengths being 128,129, 196,512, 84,812, 43,695, and 5,596 bp, respectively. Plasmid p1_Kpn_XM9 (128,219 bp) contained four resistance genes, bla CTX-M-65 , bla TEM-1B , rmt B, and two copies of bla KPC-2 . Genes bla KPC-2 were bracketed by ISKpn17 and ISKpn16 within a new composite Tn3-like TnAs1. The two tandem repeats, positioned opposite each other, were spaced 93,447 bp apart in p1_Kpn_XM9. Kpn_XM9 belonged to K64 and sequence type (ST) 11. The Kpn_XM9 was resistant to amikacin, aztreonam, ticarcillin/clavulanic acid, piperacillin/tazobactam, ceftazidime, cefepime, imipenem, meropenem, tobramycin, ciprofloxacin, levofloxacin, doxycycline, minocycline, tigecycline, colistin, and trimethoprim/sulfamethoxazole; it was barely susceptible to CZA with a minimum inhibitory concentration of 8/4 µg/mL, which declined to 2/4 µg/mL after a 18,555 bp nucleotide was knocked out and one copy of bla KPC-2 was sustained on p1_Kpn_XM9. Kpn_XM9 had virulence genes encoding Types 1 and 3 fimbriae, four siderophores, and capsular polysaccharide anchoring protein but no genes upregulating capsular polysaccharide synthesis. The Kpn_XM9 presented a classical phenotype with extreme drug resistance. The emergence of double copies of bla KPC-2 in a single plasmid from the predominant ST11 K. pneumoniae represents a new therapeutic challenge. IMPORTANCE With the wide use of ceftazidime–avibactam against carbapenem-resistant organisms, its resistance is increasingly documented; among the corresponding resistance mechanisms, mutations of bla KPC-2 or bla KPC-3 into other subtypes are dominant to date. However, more copies of bla KPC-2 may also greatly increase the minimum inhibitory concentration of ceftazidime–avibactam, which could be conferred by transposon As1 and insertion sequence 26 and should be of concern.

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Characterization of a Conjugative Hybrid Plasmid Coharboring bla _KPC-2 and bla _IMP-4 in a Klebsiella quasipneumoniae Clinical Isolate

Cited by 4 publications

References 21 publications

Difference analysis and characteristics of incompatibility group plasmid replicons in gram-negative bacteria with different antimicrobial phenotypes in Henan, China

Difference analysis and characteristics of incompatibility group plasmid replicons in gram-negative bacteria with different antimicrobial phenotypes in Henan, China

Genomic insight into the distribution and genetic environment of blaIMP-4 in clinical carbapenem-resistant Klebsiella pneumoniae strains in China

Double bla _KPC-2 copies quadrupled minimum inhibitory concentration of ceftazidime–avibactam in hospital-derived Klebsiella pneumoniae

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Characterization of a Conjugative Hybrid Plasmid Coharboring bla KPC-2 and bla IMP-4 in a Klebsiella quasipneumoniae Clinical Isolate

Cited by 4 publications

References 21 publications

Difference analysis and characteristics of incompatibility group plasmid replicons in gram-negative bacteria with different antimicrobial phenotypes in Henan, China

Difference analysis and characteristics of incompatibility group plasmid replicons in gram-negative bacteria with different antimicrobial phenotypes in Henan, China

Genomic insight into the distribution and genetic environment of blaIMP-4 in clinical carbapenem-resistant Klebsiella pneumoniae strains in China

Double bla KPC-2 copies quadrupled minimum inhibitory concentration of ceftazidime–avibactam in hospital-derived Klebsiella pneumoniae

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Characterization of a Conjugative Hybrid Plasmid Coharboring bla _KPC-2 and bla _IMP-4 in a Klebsiella quasipneumoniae Clinical Isolate

Double bla _KPC-2 copies quadrupled minimum inhibitory concentration of ceftazidime–avibactam in hospital-derived Klebsiella pneumoniae