Dominant Carbapenemase-Encoding Plasmids in Clinical Enterobacterales Isolates and Hypervirulent Klebsiella pneumoniae , Singapore

Dissemination of carbapenemase-encoding plasmids by horizontal gene transfer in multidrug-resistant bacteria is the major driver of rising carbapenem-resistance, but the conjugative mechanics and evolution of clinically relevant plasmids are not yet clear. We performed whole-genome sequencing on 1,2...

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Bibliographic Details
Published in:Emerging infectious diseases 2022-08, Vol.28 (8), p.1578-1588
Main Authors: Yong, Melvin, Chen, Yahua, Oo, Guodong, Chang, Kai Chirng, Chu, Wilson H.W, Teo, Jeanette, Venkatachalam, Indumathi, Thevasagayam, Natascha May, Sridatta, Prakki S. Rama, Koh, Vanessa, Marcoleta, Andres E, Chen, Hanrong, Nagarajan, Niranjan, Kalisvar, Marimuthu, Ng, Oon Tek, Gan, Yunn-Hwen
Format: Article
Language:English
Subjects:
Antibiotics
Antimicrobial agents
Antimicrobial resistance
bacteria
capsule
Carbapenems
Dominant Carbapenemase-Encoding Plasmids in Clinical Enterobacterales Isolates and Hypervirulent
Dosage and administration
Drug resistance
Drug resistance in microorganisms
E coli
Enterobacter
Enterobacterales
Enterobacteriaceae
Genes
Genetic aspects
Genomes
hypervirulent
Identification and classification
KPC2
Laboratories
Patient outcomes
Plasmids
Risk factors
Singapore
Testing
Varieties
Virulence
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Summary:Dissemination of carbapenemase-encoding plasmids by horizontal gene transfer in multidrug-resistant bacteria is the major driver of rising carbapenem-resistance, but the conjugative mechanics and evolution of clinically relevant plasmids are not yet clear. We performed whole-genome sequencing on 1,215 clinical Enterobacterales isolates collected in Singapore during 2010–2015. We identified 1,126 carbapenemase-encoding plasmids and discovered pKPC2 is becoming the dominant plasmid in Singapore, overtaking an earlier dominant plasmid, pNDM1. pKPC2 frequently conjugates with many Enterobacterales species, including hypervirulent Klebsiella pneumoniae, and maintains stability in vitro without selection pressure and minimal adaptive sequence changes. Furthermore, capsule and decreasing taxonomic relatedness between donor and recipient pairs are greater conjugation barriers for pNDM1 than pKPC2. The low fitness costs pKPC2 exerts in Enterobacterales species indicate previously undetected carriage selection in other ecological settings. The ease of conjugation and stability of pKPC2 in hypervirulent K. pneumoniae could fuel spread into the community.
ISSN:1080-6040
1080-6059
DOI:10.3201/eid2808.212542