Genomic Characterization of Two KPC-Producing Klebsiella Isolates Collected in 1997 in New York City

Abstract

Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae have now become a global public health threat. However, the origin of this pandemic and the characterization of pre-2003 bla KPC -harboring plasmids remain unknown. Here we used next-generation sequencing to characterize two KPC-2-producing K. pneumoniae and K. michiganensis isolates collected from a New York City hospital in 1997. Although identified in two different Klebsiella species, the bla KPC-2 gene was harbored by Tn4401b transposons on two highly similar IncN plasmids.

Epidemiological and Genetic Overview of the Klebsiella pneumoniae Carbapenemases (KPCs) in K. pneumoniae Isolated from the Clinical Samples in Iran

“…In this study, the lowest resistance was attributed to carbapenems based on the antibiotic susceptibility tests; this finding is consistent with the results of a study by Bina et al, which indicated the highest resistance to carbapenem (Bina et al, 2015). Considering the increasing spread of antimicrobial resistance (AMR) in hospital settings, the findings of the present study are similar to those reported by (Eilertson et al, 2017), and (Kontopoulou et al, 2010). These findings warrant more attention by the intensive care unit personnel to limit the potential risk of AMR in hospitals.…”

Plasmid evolution in carbapenemase‐producing Enterobacteriaceae: a review

“…Other plasmid replicon groups, such as IncN, IncP, IncX, IncU, IncI, A/C, IncR, and L/M, are also occasionally reported in KPC‐producing K. pneumoniae . Moreover, these plasmid replicon groups are also associated with K. pneumoniae strains producing other carbapenemases.…”

“…However, in the last decade, KPC has also been reported in other species of Enterobacteriaceae , including Escherichia coli , Enterobacter spp., Klebsiella oxytoca , Proteus mirabilis , Serratia marcescens , Morganella morganii , and Citrobacter freundii , among others . KPC carbapenemases are widely distributed worldwide, but they are mostly reported in the United States, where they cause majority of reported cases of infection . In the United States, KPC producers are usually associated with hospital outbreaks caused by patient‐to‐patient transmission of clonally related resistant organisms .…”

“…IncN plasmids are usually medium‐sized conjugative plasmids documented to be associated with bla VIM ‐expressing Enterobacteriaceae and bla KPC ‐expressing K. pneumoniae isolates . Plasmids, including p9 (70.6 kb), p12 (75.6 kb), pKPC‐629 (80.1 kb), pBK31551 (83.7 kb), pKO6 (65.5 kb), and pKp58‐N (69.8 kb), have been documented as carriers of bla KPC . Most of the sequences of these plasmids have been deposited in GenBank without a corresponding published article (accession numbers are given in Table S1, online only).…”

“…KPC‐2 was commonly associated with multiple STs, but ST258 was the most prevalent in the United States. The IncF groups dominate in the spread of KPC‐2 and KPC‐3 in the United States and other countries, including Australia, Canada, China, Italy, Romania, and Spain Only one study has reported on IncF groups in KPC‐3 in Portugal and Romania . Few occurrences were also reported in other countries, including the United States, Mexico, and Spain.…”