Infection and Drug Resistance (Oct 2018)

Comparative analysis of bla KPC-2- and rmtB-carrying IncFII-family pKPC-LK30/pHN7A8 hybrid plasmids from Klebsiella pneumoniae CG258 strains disseminated among multiple Chinese hospitals

  • Shi L,
  • Feng J,
  • Zhan Z,
  • Zhao Y,
  • Zhou H,
  • Mao H,
  • Gao Y,
  • Zhang Y,
  • Yin Z,
  • Gao B,
  • Tong Y,
  • Luo Y,
  • Zhang D,
  • Zhou D

Journal volume & issue
Vol. Volume 11
pp. 1783 – 1793

Abstract

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Lining Shi,1,* Jiao Feng,2,* Zhe Zhan,2 Yuzong Zhao,2,3 Haijian Zhou,4 Haifeng Mao,5 Yingjie Gao,6 Ying Zhang,7 Zhe Yin,2 Bo Gao,2 Yigang Tong,2 Yanping Luo,7 Defu Zhang,2,3 Dongsheng Zhou2 1Institute of Medical Laboratory Sciences, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, China; 2State Key Laboratory of Pathogen & Biosecurity, Beijing Institute of Microbiology & Epidemiology, Beijing 100071, China; 3College of Food Science & Project Engineering, Bohai University, Jinzhou 121013, China; 4National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; 5Department of Laboratory Medicine, The First People’s Hospital of Lianyungang, Lianyungang 222002, China; 6College of Veterinary Medicine, Jilin University, Changchun 130062, China; 7Medical Laboratory Center, Chinese People’s Liberation Army General Hospital, Beijing 100085, China *These authors contributed equally to this work Background: We recently reported the complete sequence of a blaKPC-2- and rmtB-carrying IncFII-family plasmid p675920-1 with the pKPC-LK30/pHN7A8 hybrid structure. Comparative genomics of additional sequenced plasmids with similar hybrid structures and their prevalence in blaKPC-carrying Klebsiella pneumoniae strains from China were investigated in this follow-up study. Methods: A total of 51 blaKPC-carrying K. pneumoniae strains were isolated from 2012 to 2016 from five Chinese hospitals and genotyped by multilocus sequence typing. The blaKPC-carrying plasmids from four representative strains were sequenced and compared with p675920-1 and pCT-KPC. Plasmid transfer, carbapenemase activity determination, and bacterial antimicrobial susceptibility test were performed to characterize resistance phenotypes mediated by these plasmids. The prevalence of pCT-KPC-like plasmids in these blaKPC-carrying K. pneumoniae strains was screened by PCR. Result: The six KPC-encoding plasmids p1068-KPC, p20049-KPC, p12139-KPC and p64917-KPC (sequenced in this study) and p675920-1 and pCT-KPC slightly differed from one another due to deletion and acquisition of various backbone and accessory regions. Two major accessory resistance regions, which included the blaKPC-2 region harboring blaKPC-2 (carbapenem resistance) and blaSHV-12 (β-lactam resistance), and the MDR region carrying rmtB (aminoglycoside resistance), fosA3 (fosfomycin resistance), blaTEM-1B (β-lactam resistance) and blaCTX-M-65 (β-lactam resistance), were found in each of these six plasmids and exhibited several parallel evolution routes. The pCT-KPC-like plasmids were present in all the 51 K. pneumoniae isolates, all of which belonged to CG258. Conclusion: There was clonal dissemination of K. pneumoniae CG258 strains, harboring blaKPC-2- and rmtB-carrying IncFII-family pKPC-LK30/pHN7A8 hybrid plasmids, among multiple Chinese hospitals. Keywords: Klebsiella pneumoniae, multidrug resistance, carbapenemase, plasmids

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