Emergence of carbapenem-resistant Klebsiella pneumoniae harbouring bla OXA-48-like genes in China
Ying Chen, Fang Li, Yunxing Yang, Rushuang Yan, Ying Fu, Ping Shen, Dongdong Zhao, Yan Chen, Xiaoting Hua, Yan Jiang, Robert A. Moran, Willem van Schaik, Yunsong Yu
Abstract
Klebsiella pneumoniae strains carrying OXA-48-like carbapenemases are increasingly prevalent across the globe. There is thus an urgent need to better understand the mechanisms that underpin the dissemination of bla OXA-48 -like carbapenemases. To this end, four ertapenem-resistant K. pneumoniae isolates producing OXA-48-like carbapenemases were isolated from two patients. Genome sequencing revealed that one sequence type (ST) 17 isolate carried bla OXA-181 , whilst three isolates from a single patient, two ST76 and one ST15, carried bla OXA-232 . The 50514 bp bla OXA-181 -harbouring plasmid, pOXA-181_YML0508, was X3-type with a conjugation frequency to Escherichia coli of 1.94×10 −4 transconjugants per donor. The bla OXA-232 gene was located on a 6141 bp ColKP3-type plasmid, pOXA-232_WSD, that was identical in the ST76 and ST15 K. pneumoniae isolates. This plasmid could be transferred from K. pneumoniae to E. coli at low frequency, 8.13×10 −6 transconjugants per donor. Comparative analysis revealed that the X3 plasmid acquired the bla OXA-48 -like gene via IS 3000 -mediated co-integration of the ColKP3-type plasmid. Our study highlights how plasmid integration and rearrangements can contribute to the spread of bla OXA-48 -like genes, which provides important clues for clinical prevention of the dissemination of K. pneumoniae strains carrying bla OXA-48 -like carbapenemases.