Frontiers in Microbiology (Aug 2023)
Carbapenem-resistant Citrobacter freundii harboring blaKPC−2 and blaNDM−1: a study on their transferability and potential dissemination via generating a transferrable hybrid plasmid mediated by IS6100
- Feilong Zhang,
- Feilong Zhang,
- Feilong Zhang,
- Ziyao Li,
- Ziyao Li,
- Ziyao Li,
- Xinmeng Liu,
- Xinmeng Liu,
- Xinmeng Liu,
- Yanning Hu,
- Yanning Hu,
- Yanning Hu,
- Jiankang Zhao,
- Jiankang Zhao,
- Yulin Zhang,
- Yulin Zhang,
- Yanyan Fan,
- Yanyan Fan,
- Zichen Lei,
- Zichen Lei,
- Zichen Lei,
- Xinrui Yang,
- Xinrui Yang,
- Xinrui Yang,
- Zhihua Li,
- Zhihua Li,
- Zhihua Li,
- Chen Li,
- Chen Li,
- Chen Li,
- Chen Li,
- Yongli Wu,
- Yongli Wu,
- Yongli Wu,
- Binghuai Lu,
- Binghuai Lu,
- Binghuai Lu,
- Binghuai Lu,
- Binghuai Lu
Affiliations
- Feilong Zhang
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
- Feilong Zhang
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Feilong Zhang
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Ziyao Li
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Ziyao Li
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Ziyao Li
- China-Japan Friendship Institute of Clinical Medical Sciences, Beijing, China
- Xinmeng Liu
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
- Xinmeng Liu
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Xinmeng Liu
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Yanning Hu
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
- Yanning Hu
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Yanning Hu
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Jiankang Zhao
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Jiankang Zhao
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Yulin Zhang
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Yulin Zhang
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Yanyan Fan
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Yanyan Fan
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Zichen Lei
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Zichen Lei
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Zichen Lei
- China-Japan Friendship Institute of Clinical Medical Sciences, Beijing, China
- Xinrui Yang
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Xinrui Yang
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Xinrui Yang
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Zhihua Li
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
- Zhihua Li
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Zhihua Li
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Chen Li
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
- Chen Li
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Chen Li
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Chen Li
- Liuyang Traditional Chinese Medicine Hospital, Changsha, Hunan, China
- Yongli Wu
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Yongli Wu
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Yongli Wu
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Binghuai Lu
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
- Binghuai Lu
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
- Binghuai Lu
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Binghuai Lu
- China-Japan Friendship Institute of Clinical Medical Sciences, Beijing, China
- Binghuai Lu
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- DOI
- https://doi.org/10.3389/fmicb.2023.1239538
- Journal volume & issue
-
Vol. 14
Abstract
IntroductionThe increase in clinical Enterobacteriaceae with dual carbapenemase has become a serious healthcare concern. It is essential to characterize the transferability and potential dissemination of blaKPC−2- and blaNDM−1-coharboring carbapenem-resistant Citrobacter freundii (CRCF).MethodsFour blaKPC−2- and blaNDM−1-coharboring CRCF strains were collected from our surveillance of the prevalence of carbapenem-resistant Enterobacteriaceae. The isolates were assessed using species identification, antimicrobial susceptibility testing, conjugation assays, whole-genome sequencing, plasmid stability, and fitness costs. Clonality, genome, plasmidome, and phylogeny were analyzed to reveal potential dissemination.ResultsThree ST523 blaKPC−2- and blaNDM−1-coharboring CRCF strains, collected from the same hospital within 1 month, exhibited high homology (both identity and coverage >99%), implying clonal dissemination and a small-scale outbreak. Moreover, the blaKPC−2 and blaNDM−1 genes were coharbored on an IncR plasmid, probably generated by a blaKPC−2-harboring plasmid acquiring blaNDM−1, in these three strains. Importantly, the IncR plasmid may form a transferable hybrid plasmid, mediated by IS6100 via transposition, with another IncFII plasmid included in the same C. freundii strain. Furthermore, the blaKPC−2 and blaNDM−1 of the fourth CRCF strain are located on two different non-transferable plasmids lacking complete transfer elements. Additionally, throughout the course of the 10-day continuous passage, the genetic surroundings of blaNDM−1 in four CRCF strains were gradually excised from their plasmids after the 8th day, whereas they maintained 100% retention for blaKPC−2. Genome and plasmidome analyses revealed that blaKPC−2- or blaNDM−1-harboring C. freundii were divergent, and these plasmids have high homology to plasmids of other Enterobacteriaceae.ConclusionClonal dissemination of ST523 blaKPC−2- and blaNDM−1-coharboring CRCF strains was detected, and we first reported blaKPC−2 and blaNDM−1 concomitantly located on one plasmid, which could be transferred with mediation by IS6100 via transposition. Continued surveillance should urgently be implemented.
Keywords
- carbapenem-resistant Citrobacter freundii
- KPC-2- and NDM-1-coproducing CRCF
- hybrid plasmid
- transposition recombination
- IS6100
