Emergence and genomics of OXA-232-producing Klebsiella pneumoniae in a hospital in Yancheng, China

Zhu, Zhichen; Huang, Haifeng; Xu, Ye; Wang, Min; Lv, Jinnan; Xu, Linlin; Shi, Chunlei; Xu, Ya; Chen, Liang; Du, Hong

doi:10.1016/j.jgar.2021.05.015

Cited by 10 publications

(7 citation statements)

References 44 publications

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“…Recent data suggested that the dissemination of OXA-232-producing K. pneumoniae is increasing rapidly, especially in Asia and the Middle East (7,11). In our study, about a third of patients had recently visited 1 of these regions.…”

Section: Discussionmentioning

confidence: 47%

“…Furthermore, the genetic environment surrounding the bla OXA-232 gene is comparable to that of the bla OXA-181 gene, suggesting that OXA-232 is derived directly from OXA-181 (4).Previous research has mainly identified OXA-232 in Escherichia coli and K. pneumoniae isolates and has found that this variant is endemic in China, India, South Korea, and Thailand (4,7,8). For K. pneumoniae, several outbreaks have been reported with different sequence types (STs), including ST-14, ST-15, ST-16, ST-23, [9][10][11]. Moreover, to the best of our knowledge, there are no data from France regarding OXA-232 outbreaks and epidemiology since the first description of 1 E. coli ST-2968 and 2 K. pneumoniae ST-14 isolates from patients returning to France from India in 2012 (5).In addition, strains coproducing NDM and OXA-232 have been reported in several countries (12)(13)(14).…”

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confidence: 99%

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Polyclonal Dissemination of OXA-232 Carbapenemase–Producing Klebsiella pneumoniae, France, 2013–2021

Emeraud¹,

Birer²,

Girlich³

et al. 2022

Emerg. Infect. Dis.

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T he massive dissemination of carbapenemase-producing Enterobacterales poses a global threat to public health. Carbapenem antibiotics remain the last line of defense against highly resistant Enterobacterales. Carbapenemases have been identified in 3 of the 4 classes of the Ambler classification: class A carbapenemases (mostly Klebsiella pneumoniae carbapenemase types) (1), class B carbapenemases or metalloβ-lactamases (mostly New Delhi metallo-β-lactamase [NDM], Verona integron-mediated metallo-βlactamase [VIM], or imipenemase types) (2), and class D carbapenemases (mostly oxacillinases [OXAs] of OXA-48 types) (3). In France, the most prevalent carbapenemases are of OXA-48 type (4). According to the Beta-Lactamase Database (http://www.bldb. eu), >50 OXA-48-like carbapenemase variants have been identified. OXA-48, OXA-162, OXA-181, OXA-232, OXA-204, and OXA-244 are the most common enzymes identified among these carbapenemases (4).OXA-232 differs from OXA-181 by a single amino acid substitution (Arg214Ser), differing itself from OXA-48 by 4 substitutions (Thr104Ala, Asn110Asp, Glu168Gln, and Ser171Ala). OXA-232 has been demonstrated to possess a weaker hydrolytic activity toward carbapenems but a stronger ability to hydrolyze penicillins compared with OXA-48 and OXA-181 (5,6). The bla OXA-232 gene usually is located on a 6-kb nonconjugative ColE-type plasmid within a truncated Tn2013-like transposon (5). Furthermore, the genetic environment surrounding the bla OXA-232 gene is comparable to that of the bla OXA-181 gene, suggesting that OXA-232 is derived directly from OXA-181 (4).Previous research has mainly identified OXA-232 in Escherichia coli and K. pneumoniae isolates and has found that this variant is endemic in China, India, South Korea, and Thailand (4,7,8). For K. pneumoniae, several outbreaks have been reported with different sequence types (STs), including ST-14, ST-15, ST-16, ST-23, [9][10][11]. Moreover, to the best of our knowledge, there are no data from France regarding OXA-232 outbreaks and epidemiology since the first description of 1 E. coli ST-2968 and 2 K. pneumoniae ST-14 isolates from patients returning to France from India in 2012 (5).In addition, strains coproducing NDM and OXA-232 have been reported in several countries (12)(13)(14). In these strains, bla NDM and bla OXA-232 are carried by 2 different plasmids (13). The bla OXA-232 gene is located on a ColE-type plasmid, whereas the bla NDM gene usually is carried by an incF-type plasmid (8).Given the increasing prevalence of OXA-232producing Enterobacterales in Europe, it is crucial to better understand the driving forces of such

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Section: Discussionmentioning

confidence: 47%

mentioning

confidence: 99%

Polyclonal Dissemination of OXA-232 Carbapenemase–Producing Klebsiella pneumoniae, France, 2013–2021

Emeraud¹,

Birer²,

Girlich³

et al. 2022

Emerg. Infect. Dis.

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“…OXA-232-producing K. pneumoniae strains have been reported in Zhejiang and Shanghai, China (Shen et al, 2020b;Shi et al, 2020;Jia et al, 2021), but to our knowledge, no comprehensive phylogenetic analysis for ST15 K. pneumoniae isolates collected from various countries has been performed before. Moreover, a study by Zhu et al in Yancheng, China reported clonal dissemination of ST15 OXA-232-producing K. pneumoniae strains (Zhu et al, 2021). Based on the short-read Illumina whole-genome sequencing (WGS), bla CTX-M-15 was found in an IncFIIK-type plasmid (Zhu et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, a study by Zhu et al in Yancheng, China reported clonal dissemination of ST15 OXA-232-producing K. pneumoniae strains (Zhu et al, 2021). Based on the short-read Illumina whole-genome sequencing (WGS), bla CTX-M-15 was found in an IncFIIK-type plasmid (Zhu et al, 2021). In addition, there are no further corresponding description about rmpA2-related virulence plasmid structure and virulence assessment experiments in their ST15 OXA-232-producing K. pneumoniae strains.…”

Section: Introductionmentioning

confidence: 99%

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Whole genome sequencing of OXA-232-producing wzi93-KL112-O1 carbapenem-resistant Klebsiella pneumoniae in human bloodstream infection co-harboring chromosomal ISEcp1-based blaCTX-M-15 and one rmpA2-associated virulence plasmid

Tian

Xing²,

Zhao³

et al. 2022

Front. Cell. Infect. Microbiol.

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ObjectivesTo characterize one OXA-232-producing wzi93-KL112-O1 carbapenem-resistant Klebsiella pneumoniae (CRKP) co-harboring chromosomal blaCTX-M-15 and one rmpA2-associated virulence plasmid.MethodsMinimum inhibitory concentrations (MICs) were measured via broth microdilution method. Conjugation, chemical transformation, string test and Galleria mellonella infection model experiments were also conducted. Whole-genome sequencing (WGS) was performed on the Illumina and Nanopore platforms. Antimicrobial resistance determinants were identified using ABRicate program with ResFinder database. Insertion sequences (ISs) were identified using ISfinder. Bacterial virulence factors were identified using virulence factor database (VFDB). Wzi, capsular polysaccharide (KL) and lipoolygosaccharide (OCL) were analyzed using Kleborate with Kaptive. Phylogenetic analysis of 109 ST15 K. pneumoniae strains was performed using core genome multilocus sequence typing (cgMLST) on the Ridom SeqSphere+ server. MLST, replicons type, SNP strategies and another cgMLST analysis for 45 OXA-232-producing K. pneumoniae strains were further conducted using BacWGSTdb server.ResultsK. pneumoniae KPTCM strain belongs to ST15 with wzi93, KL112 and O1. It possessed a multidrug-resistant (MDR) profile and was resistant to carbapenems (meropenem and ertapenem), ciprofloxacin and amikacin. Virulence assays demonstrated KPTCM strain possesses a low virulence phenotype. WGS revealed it contained one circular chromosome and nine plasmids. The carbapenemase-encoding gene blaOXA-232 was located in a 6141-bp ColKP3-type non-conjugative plasmid and flanked by ΔISEcp1 and ΔlysR-ΔereA. Interestingly, blaCTX-M-15 was located in the chromosome mediated by ISEcp1-based transposon Tn2012. Importantly, it harbored a rmpA2-associated pLVPK-like virulence plasmid with iutA-iucABCD gene cluster and one IS26-mediated MDR fusion plasmid according to 8-bp (AGCTGCAC or GGCCTTTG) target site duplications (TSD). Based on the cgMLST and SNP analysis, data showed OXA-232-producing ST15 K. pneumoniae isolates were mainly isolated from China and have evolved in recent years.ConclusionsEarly detection of CRKP strains carrying chromosomal blaCTX-M-15, OXA-232 carbapenemase and pLVPK-like virulence plasmid is recommended to avoid the extensive spread of this high-risk clone.

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Virulence Factors in Klebsiella pneumoniae: A Literature Review

Monteiro,

Cordeiro,

Reis

2024

Indian J Microbiol

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Emergence and genomics of OXA-232-producing Klebsiella pneumoniae in a hospital in Yancheng, China

Cited by 10 publications

References 44 publications

Polyclonal Dissemination of OXA-232 Carbapenemase–Producing Klebsiella pneumoniae, France, 2013–2021

Polyclonal Dissemination of OXA-232 Carbapenemase–Producing Klebsiella pneumoniae, France, 2013–2021

Whole genome sequencing of OXA-232-producing wzi93-KL112-O1 carbapenem-resistant Klebsiella pneumoniae in human bloodstream infection co-harboring chromosomal ISEcp1-based blaCTX-M-15 and one rmpA2-associated virulence plasmid

Virulence Factors in Klebsiella pneumoniae: A Literature Review

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