Carriage of distinct blaKPC-2 and blaOXA-48 plasmids in a single ST11 hypervirulent Klebsiella pneumoniae isolate in Egypt
Yanxian Yang, Yongqiang Yang, Mohamed Abd El-Gawad El-Sayed Ahmed, Mingyang Qin, Ruowen He, Yiping Wu, Xiaoxue Liang, Lan‐Lan Zhong, Ping Chen, Baoguo Deng, Reem Hassan, Weihong Wen, Lingqing Xu, Xubin Huang, Lin Xu, Guo‐Bao Tian
Abstract
Abstract Background Carbapenem-resistant hypervirulent K. pneumoniae (CR-hvKP) causes serious infections with significant morbidity and mortality. However, the epidemiology and transmission mechanisms of CR-hvKP and the corresponding carbapenem-resistant plasmids require further investigation. Herein, we have characterized an ST11 K. pneumoniae strain EBSI041 from the blood sample encoding both hypervirulence and carbapenem resistance phenotypes from a patient in Egypt. Results K. pneumoniae strain EBSI041 showed multidrug-resistance phenotypes, where it was highly resistant to almost all tested antibiotics including carbapenems. And hypervirulence phenotypes of EBSI041 was confirmed by the model of Galleria mellonella infection. Whole-genome sequencing analysis showed that the hybrid plasmid pEBSI041-1 carried a set of virulence factors rmpA , rmpA2 , iucABCD and iutA , and six resistance genes aph(3′)-VI , armA , msr(E) , mph(E), qnrS , and sul2 . Besides, bla OXA-48 and bla SHV-12 were harboured in a novel conjugative IncL-type plasmid pEBSI041-2. The bla KPC-2 -carrying plasmid pEBSI041-3, a non-conjugative plasmid lacking the conjugative transfer genes, could be transferred with the help of pEBSI041-2, and the two plasmids could fuse into a new plasmid during co-transfer. Moreover, the emergence of the p16HN-263_KPC-like plasmids is likely due to the integration of pEBSI041-3 and pEBSI041-4 via IS 26 -mediated rearrangement. Conclusion To the best of our knowledge, this is the first report on the complete genome sequence of KPC-2- and OXA-48-coproducing hypervirulent K. pneumoniae from Egypt. These results give new insights into the adaptation and evolution of K. pneumoniae during nosocomial infections.