Genome sequencing unveils <i>bla</i> <sub>KPC-2</sub> -harboring plasmids as drivers of enhanced resistance and virulence in nosocomial <i>Klebsiella pneumoniae</i>
Xinhong Han, Junxin Zhou, Lifei Yu, Lina Shao, Shiqi Cai, Huangdu Hu, Qiucheng Shi, Zhengan Wang, Xiaoting Hua, Yan Jiang, Yunsong Yu
Abstract
-harboring plasmids) population structure and evolutionary characteristics in clinical settings. Long-read sequencing was performed in genetically closely related strains, enabling the high-resolution analysis of evolution pathway between or within pKPC-2 subgroups. We revealed the extremely high rates of multicopy antibiotic resistance genes (ARGs) in clinical settings and its effect on resistance profile toward novel β-lactam/β-lactamase inhibitor combinations, which belongs to the last line treatment choices toward CRKP infection. A novel hybrid pKPC-2 carrying CRKP with enhanced resistance and virulence level was captured during its clonal spread between patients and ward environment. These evidences highlight the threat of pKPC-2 to CRKP treatment and control. Thus, surveillance and timely disinfection in clinical settings should be practiced to prevent transmission of CRKP carrying threatful pKPC-2. And rational use of antibiotics should be called for to prevent inducing of pKPC-2 evolution, especially the multicopy ARGs.