Prevalence of ST1049-KL5 carbapenem-resistant Klebsiella pneumoniae with a blaKPC-2 and blaNDM-1 co-carrying hypertransmissible IncM1 plasmid

• Published in: Communications biology 2024-06, Vol.7 (1), p.695, Article 695
• Main Authors: Liu, Hongmao, Xiang, Yating, Xiong, Mengyuan, Xiao, Xiao, Zhou, Junying, Tian, Hongpan, Chen, Qingsong, Li, Yirong
• Format: Article
• Language: English
• Subjects: 38/77; 42/41; 45/23; 45/29; 631/326/22/1434; 692/699/255/1318; Biomedical and Life Sciences; Carbapenems; Conjugation; Disease control; Genetic analysis; Genomes; Genomic analysis; Infections; Klebsiella pneumoniae; Life Sciences; Multilocus sequence typing; Nucleotide sequence; Plasmids; Public health; Pulsed-field gel electrophoresis; Single-nucleotide polymorphism; Surveillance; Whole genome sequencing
• ISSN: 2399-3642; 2399-3642
• DOI: 10.1038/s42003-024-06398-w

Infection caused by KPC and NDM carbapenemases co-producing Klebsiella pneumoniae (KPC_NDM_CRKP) poses serious public health concerns. Here, we elucidate the prevalence of a hypertransmissible lncM1 plasmid, pKPC_NDM, co-carrying bla KPC-2 and bla NDM-1 genes in sequence type 1049 K_locus 5 (ST1049-KL5) KPC_NDM_CRKP isolates. Genetic and clonal relatedness analyses using pulsed-field gel electrophoresis, single nucleotide polymorphism analysis and core genome multilocus sequence typing suggested clonal dissemination of ST1049-KL5 KPC_NDM_CRKP strains in our hospital. Whole genome sequencing identified an identical 76,517 bp- bla KPC-2 and bla NDM-1 genes co-carrying IncM1 plasmid pKPC_NDM and a pLVPK-like hypervirulent plasmid in all ST1049-KL5 KPC_NDM_CRKP isolates. pKPC_NDM shared 100% identity with a previously sequenced plasmid CRKP35_unnamed4, demonstrating high transferability in conjugation assay, with conjugation frequencies reaching 10 -4 and 10 -5 in Escherichia coli and K. pneumoniae recipients, respectively. It also maintained favorable stability and flexible compatibility, with retention rates exceeding 80% after 10 days of continuous passage, and could be compatible with pre-existing bla KPC - or bla NDM -carrying plasmids in recipient strains. This study summarizes the characteristics of KPC_NDM_CRKP outbreaks and highlights the importance of ongoing surveillance and infection control strategies to address the challenges posed by ST1049 K. pneumoniae strains. The study focuses on a bla KPC-2 and bla NDM-1 co-carrying hypertransmissible IncM1 plasmid in ST1049 CRKP strains, highlights the importance of ongoing surveillance and infection control strategies to address the challenges posed by ST1049  K. pneumoniae .