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

在中国多家医院传播的肺炎克雷伯菌 CG258 菌株中携带 bla KPC-2 和 rmtB 的 IncFII 家族 pKPC-LK30/pHN7A8 杂交质粒的比较分析

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作者:Lining Shi, Jiao Feng, Zhe Zhan, Yuzong Zhao, Haijian Zhou, Haifeng Mao, Yingjie Gao, Ying Zhang, Zhe Yin, Bo Gao, Yigang Tong, Yanping Luo, Defu Zhang, Dongsheng Zhou

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 bla KPC-carrying Klebsiella pneumoniae strains from China were investigated in this follow-up study.

Conclusion

There was clonal dissemination of K. pneumoniae CG258 strains, harboring bla KPC-2- and rmtB-carrying IncFII-family pKPC-LK30/pHN7A8 hybrid plasmids, among multiple Chinese hospitals.

Methods

A total of 51 bla KPC-carrying K. pneumoniae strains were isolated from 2012 to 2016 from five Chinese hospitals and genotyped by multilocus sequence typing. The bla KPC-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 bla KPC-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), bla TEM-1B (β-lactam resistance) and bla CTX-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.

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