Emergence of a novel conjugative hybrid virulence multidrug-resistant plasmid in extensively drug-resistant Klebsiella pneumoniae ST15

Li, Ruichao; Cheng, Jing; Dong, Huiyue; Li, Leyuan; Liu, Wentian; Zhang, Chunli; Feng, Xin; Qin, Shangshang

doi:10.1016/j.ijantimicag.2020.105952

Cited by 47 publications

(51 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, as reported by Li and colleagues [20], the KPC-producing K. pneumoniae ST15 strains that were characterized in our hospital were multidrug resistant, though the IPM and MEM MICs of most strains were 4-8-fold lower than those of the corresponding ST11 strains. In particular, the IPM MICs of 81.3% (26/32) of strains were 8 µg/mL or even less, which is considered to be the threshold of the high-dose continuous infusion of carbapenem (HDCI) strategy for anti-infection therapy [22].…”

Section: Discussionsupporting

confidence: 87%

“…A fatal outbreak of carbapenemresistant hypervirulent K. pneumoniae ST11 strains has been reported in a Chinese hospital [17]. The convergence of bla KPC and hypervirulence genes within the same K. pneumoniae ST15 strain has also been identi ed in China and Vietnam [20,23]. Fortunately, none of the ST15 strains detected in this study were positive for hypervirulence genes, and the infection rates of the KPC-producing K. pneumoniae ST15 strains were lower (P = 0.018) than those of the corresponding ST11 strains in our hospital.…”

Section: Discussionmentioning

confidence: 98%

“…In addition, unlike the ST11 strains, no hypervirulence genes were detected in KP18069. Although the genome sequence was highly homologous to that of the K. pneumoniae ST15 strain KP17-16, KP18069 lacks the virulence plasmid p17-16-vir (MK191024), which is greatly associated with severe infections [20].…”

Section: Discussionmentioning

confidence: 99%

“…The genome sequence of KP18069 was highly homologous to the K. pneumoniae ST15 strain KP17-16, which was characterized in Henan Province of China [20]. They shared chromosome query coverage and identity of 99% and 100%, respectively.…”

Section: Wgs and Comparative Analysismentioning

confidence: 99%

See 3 more Smart Citations

Outbreak of KPC-producing Klebsiella pneumoniae ST15 strains in a Chinese tertiary hospital: resistance and virulence analyses

Huang

Chen

Zhao

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major cause of clinical infection. However, KPC-producing K. pneumoniae ST15 strains are occasionally identified and have never been reported to cause hospital outbreaks in China. Methods In this study, pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing (WGS) were used to characterize 32 KPC-producing K. pneumoniae ST15 strains, which were collected at a Chinese tertiary hospital. Susceptibilities, resistance genes, virulence factors and clinical performances of the ST15 strains were comparatively analysed with corresponding ST11 strains. Results The ST15 strains were distributed in 7 wards, mainly in the intensive care unit (ICU, 24/32, 75%). PFGE results from 24 strains covering all the wards presented a similarity of more than 92%, indicating clonal spread. In 84% of the ST15 strains, the imipenem (IPM) and meropenem (MEM) minimum inhibitory concentrations (MICs) were ≤ 8 and ≤ 16 µg/mL, respectively, both of which were 4-fold lower than those of the ST11 strains. The infection rates of the ST15 and ST11 strains were 28.1% and 43.9%, respectively (P = 0.018). PCR evaluation and WGS indicated that all the CRKP strains shared a 100% identical blaKPC−2 genetic structure, though a synonymous mutation and a Gly115-Asp116 (GD) insertion in the OmpK36 were identified in the ST15 and ST11 strains, respectively. None of the ST15 strains were positive for hypervirulence factors; however, the positive rate was 92.7% (38/41) in the ST11 isolates. Conclusion To the best of our knowledge, this is the first description of nosocomial outbreaks caused by KPC-producing K. pneumoniae ST15 strains in China. The ST15 strains had low carbapenem resistance and virulence, emphasizing the importance of careful evaluation of phenotypic and genetic characteristics for anti-infection therapy.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Wgs and Comparative Analysismentioning

confidence: 99%

See 2 more Smart Citations

Outbreak of KPC-producing Klebsiella pneumoniae ST15 strains in a Chinese tertiary hospital: resistance and virulence analyses

Huang

Chen

Zhao

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Virulence plasmids can be fully or partially responsible for the pathogenicity of the host pathogen (e.g., pINV of enteroinvasive E. coli and pSLT of Salmonella enterica serovar typhimurium, respectively), while MDR plasmids can confer on host cells a great fitness advantage when they are challenged by corresponding antibiotics. Note that composite plasmids carrying both virulence and MDR genes are also emerging [ 40 , 41 ]. In virulence plasmids, the presence of active partitioning, PSK and multimer resolution mechanisms ensures their prevalence [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Vertical and Horizontal Transmission of ESBL Plasmid from Escherichia coli O104:H4

Daniel

Goldlust

Quèbre

et al. 2020

Genes

View full text Add to dashboard Cite

Multidrug resistance (MDR) often results from the acquisition of mobile genetic elements (MGEs) that encode MDR gene(s), such as conjugative plasmids. The spread of MDR plasmids is founded on their ability of horizontal transference, as well as their faithful inheritance in progeny cells. Here, we investigated the genetic factors involved in the prevalence of the IncI conjugative plasmid pESBL, which was isolated from the Escherichia coli O104:H4 outbreak strain in Germany in 2011. Using transposon-insertion sequencing, we identified the pESBL partitioning locus (par). Genetic, biochemical and microscopic approaches allowed pESBL to be characterized as a new member of the Type Ib partitioning system. Inactivation of par caused mis-segregation of pESBL followed by post-segregational killing (PSK), resulting in a great fitness disadvantage but apparent plasmid stability in the population of viable cells. We constructed a variety of pESBL derivatives with different combinations of mutations in par, conjugational transfer (oriT) and pnd toxin-antitoxin (TA) genes. Only the triple mutant exhibited plasmid-free cells in viable cell populations. Time-lapse tracking of plasmid dynamics in microfluidics indicated that inactivation of pnd improved the survival of plasmid-free cells and allowed oriT-dependent re-acquisition of the plasmid. Altogether, the three factors—active partitioning, toxin-antitoxin and conjugational transfer—are all involved in the prevalence of pESBL in the E. coli population.

show abstract

Acquisition of a novel conjugative multidrug‐resistant hypervirulent plasmid leads to hypervirulence in clinical carbapenem‐resistant Klebsiella pneumoniae strains

Li,

Jia,

Wan

et al. 2023

mLife

View full text Add to dashboard Cite

The co‐occurrence of plasmid‐mediated multidrug resistance and hypervirulence in epidemic carbapenem‐resistant Klebsiella pneumoniae has emerged as a global public health issue. In this study, an ST23 carbapenem‐resistant hypervirulent K. pneumoniae (CR‐HvKP) strain VH1‐2 was identified from cucumber in China and harbored a novel hybrid plasmid pVH1‐2‐VIR. The plasmid pVH1‐2‐VIR carrying both virulence and multidrug‐resistance (MDR) genes was likely generated through the recombination of a virulence plasmid and an IncFIIK conjugative MDR plasmid in clinical ST23 18622 isolated from a sputum sample. The plasmid pVH1‐2‐VIR exhibited the capacity for transfer to the clinical ST11 carbapenem‐resistant K. pneumoniae (CRKP) strain via conjugation assay. Acquisition of pVH1‐2‐VIR plasmid directly converted a CRKP into CR‐HvKP strain characterized by hypermucoviscosity, heightened virulence for Galleria mellonella larvae, and increased colonization ability in the mouse intestine. The emergence of such a hybrid plasmid may expedite the spread of CR‐HvKP strains, posing a significant risk to human health.

show abstract

Emergence of a novel conjugative hybrid virulence multidrug-resistant plasmid in extensively drug-resistant Klebsiella pneumoniae ST15

Cited by 47 publications

References 21 publications

Outbreak of KPC-producing Klebsiella pneumoniae ST15 strains in a Chinese tertiary hospital: resistance and virulence analyses

Outbreak of KPC-producing Klebsiella pneumoniae ST15 strains in a Chinese tertiary hospital: resistance and virulence analyses

Vertical and Horizontal Transmission of ESBL Plasmid from Escherichia coli O104:H4

Acquisition of a novel conjugative multidrug‐resistant hypervirulent plasmid leads to hypervirulence in clinical carbapenem‐resistant Klebsiella pneumoniae strains

Contact Info

Product

Resources

About