<p>The first report of a novel IncHI1B <em>bla</em>_SIM-1-carrying megaplasmid pSIM-1-BJ01 from a clinical <em>Klebsiella pneumoniae</em> isolate</p>

Abstract

Background: A rare member of metallo-β-lactamases genes, bla SIM-1 , carried by a 316-kb plasmid designated pSIM-1-BJ01 was isolated from a clinical cephalosporins- and carbapenem-resistant Klebsiella pneumoniae 13624. This is the first sequence report of a transferable bla SIM-1 -carrying conjugative plasmid isolated from K. pneumoniae . Purpose: The sequence analysis of pSIM-1-BJ01 will help us to identify genes responsible for conjugation, plasmid maintenance and drug resistance, to understand the evolution and control the dissemination of resistance plasmids. Patients and methods: K. pneumoniae 13624 was isolated from the urine specimen of a patient. Bacterial genomic DNA was sequenced with PacBio RSII platform. Results: Most of the pSIM-1-BJ01 backbone matches that of pRJA166a, which was isolated from a clinical hypervirulent K. pneumoniae ST23 strain at Shanghai, China, recently. The highly homologous backbones between the two plasmids imply the close relationship of evolution. Two different multidrug-resistant regions both carrying the class 1 integrons with different resistance genes have been assembled into the pSIM-1-BJ01. Besides, the other two resistance plasmids, pKP13624-1 carrying bla TEM-1 and bla CTX-M-15 and pKP13624-2 carrying bla CTX-M-14 and bla LAP-2 were also identified. Conclusion: The emergence of the bla SIM-1 -carrying IncHI1B pSIM-1-BJ01 suggests the spread of bla SIM among Enterobacteriaceae is possible. We should pay more attention to supervise and control the dissemination of hypervirulent carbapenem-resistant K. pneumonia in public hospitals.

The Current Burden of Carbapenemases: Review of Significant Properties and Dissemination among Gram-Negative Bacteria

“…Another MBL, SIM-1 (Seoul imipenemase-1) was isolated in Korea [120] and was carried on a gene cassette inserted into a class 1 integron, found in A. baumannii strains isolated in sputum and the urine of patients with pneumonia and urinary tract infections, respectively. In 2019, the spread of bla SIM-1 to Enterobacteriaceae has been suggested after a report from China indicating a mega-plasmid harboring this gene from a clinical K. pneumoniae isolate [121]. More recently, described MBLs include DIM-1 (Dutch imipenemase-1) [122], KHM-1 (Kyorin University Hospital MBL-1) [123], and TMB-1 (Triploi MBL-1) [124] that have been reported on occasional encounters.…”

The Emergence of Carbapenem Resistant Enterobacteriaceae Producing GIM-1 and SIM-1 Clinical Isolates in Khartoum-Sudan

“…Similar results were reported for the SIM-1 gene in A. baumannii 10 in Iraq 22 and in Egypt, 20 in P. aeruginosa and recently in Egypt 23 and K. pneumoniae with ST23 strain carrying SIM-1 in China. 24 The GIM-1 and SIM-1 genes were transferred to Sudan, these can be broadly categorized into issues of emergence, spread, and clonal expansion with diversity, which include natural genetic diversification caused by mutation, horizontal gene transfer among other species, an increase in international travel and patient transfer between countries raising the possibility for further dissemination of strains carrying resistant genes. There is a need for further investigation regarding travel history, as three of the patients had previously travelled.…”