Molecular characterization of carbapenem-resistant and virulent plasmids in Klebsiella pneumoniae from patients with bloodstream infections in China

Yang, Yongqiang, Yang, Yanxian, Chen, Guanping, Lin e, Minmin, Chen, Yuan, He, Ruowen, Galvão, Klibs N., Ahmed, Mohamed AbdEl-Gawad El-Sayed, Roberts, Adam ORCID: https://orcid.org/0000-0002-0760-3088, Wu, Yiping, Zhong, Lan-Lan, Liang, Xiaoxue, Qin, Mingyang, Ding, Xin, Deng, Wenbin, Huang, Songyin, Li, Hong-Yu, Dai, Min, Chen, Ding-Qiang, Zhang, Liyan, Liao, Kang, Xia, Yong and Tian, Guo-Bao (2021) 'Molecular characterization of carbapenem-resistant and virulent plasmids in Klebsiella pneumoniae from patients with bloodstream infections in China'. Emerging Microbes and Infections, Vol 10, Issue 1, pp. 700-709.

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Abstract

Bloodstream infections (BSIs) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) are potentially life-threatening and an urgent threat to public health. The present study aims to clarify the characteristics of carbapenemase-encoding and virulent plasmids, and their interactions with the host bacterium. A total of 425 Kp isolates were collected from the blood of BSI patients from nine Chinese hospitals, between 2005 and 2019. Integrated epidemiological and genomic data showed that ST11 and ST307 Kp isolates were associated with nosocomial outbreak and transmission. Comparative analysis of 147 Kp genomes and 39 completely assembled chromosomes revealed extensive interruption of acrR by ISKpn26 in all Kp carbapenemase-2 (KPC-2)-producing ST11 Kp isolates, leading to activation of the AcrAB-Tolc multidrug efflux pump and a subsequent reduction in susceptibility to the last-resort antibiotic tigecycline and six other antibiotics. We described 29 KPC-2 plasmids showing diverse structures, two virulence plasmids in two KPC-2-producing Kp, and two novel multidrug-resistant (MDR)-virulent plasmids. This study revealed a multifactorial impact of KPC-2 plasmid on Kp, which may be associated with nosocomial dissemination of MDR isolates.

Item Type:	Article
Subjects:	QU Biochemistry > Genetics > QU 470 Genetic structures QW Microbiology and Immunology > Bacteria > QW 138 Enterobacteriaceae QW Microbiology and Immunology > QW 51 Morphology and variability of microorganisms. Microbial genetics. WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 217 Pneumococcal infections
Faculty: Department:	Biological Sciences > Department of Tropical Disease Biology
Digital Object Identifer (DOI):	https://doi.org/10.1080/22221751.2021.1906163
Depositing User:	Cathy Waldron
Date Deposited:	25 Mar 2021 11:29
Last Modified:	06 Apr 2021 12:37
URI:	https://archive.lstmed.ac.uk/id/eprint/17297

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