Carriage of distinct bla KPC-2 and bla OXA-48 plasmids in a single ST11 hypervirulent Klebsiella pneumoniae isolate in Egypt

• Published in: BMC genomics Vol. 23; no. 1; pp. 1 - 9
• Main Authors: Yanxian Yang, Yongqiang Yang, Mohamed Abd El-Gawad El-Sayed Ahmed, Mingyang Qin, Ruowen He, Yiping Wu, Xiaoxue Liang, Lan-Lan Zhong, Ping Chen, Baoguo Deng, Reem Mostafa Hassan, Weihong Wen, Lingqing Xu, Xubin Huang, Lin Xu, Guo-Bao Tian
• Format: Journal Article
• Language: English
• Published: BMC 01.12.2022
• Subjects: Egypt; Hypervirulence; K. pneumoniae; KPC-2; OXA-48
• ISSN: 1471-2164
• DOI: 10.1186/s12864-021-08214-9

Abstract Background Carbapenem-resistant hypervirulent K. pneumoniae (CR-hvKP) causes serious infections with significant morbidity and mortality. However, the epidemiology and transmission mechanisms of CR-hvKP and the corresponding carbapenem-resistant plasmids require further investigation. Herein, we have characterized an ST11 K. pneumoniae strain EBSI041 from the blood sample encoding both hypervirulence and carbapenem resistance phenotypes from a patient in Egypt. Results K. pneumoniae strain EBSI041 showed multidrug-resistance phenotypes, where it was highly resistant to almost all tested antibiotics including carbapenems. And hypervirulence phenotypes of EBSI041 was confirmed by the model of Galleria mellonella infection. Whole-genome sequencing analysis showed that the hybrid plasmid pEBSI041-1 carried a set of virulence factors rmpA, rmpA2, iucABCD and iutA, and six resistance genes aph(3′)-VI, armA, msr(E), mph(E), qnrS, and sul2. Besides, bla OXA-48 and bla SHV-12 were harboured in a novel conjugative IncL-type plasmid pEBSI041-2. The bla KPC-2-carrying plasmid pEBSI041-3, a non-conjugative plasmid lacking the conjugative transfer genes, could be transferred with the help of pEBSI041-2, and the two plasmids could fuse into a new plasmid during co-transfer. Moreover, the emergence of the p16HN-263_KPC-like plasmids is likely due to the integration of pEBSI041-3 and pEBSI041-4 via IS26-mediated rearrangement. Conclusion To the best of our knowledge, this is the first report on the complete genome sequence of KPC-2- and OXA-48-coproducing hypervirulent K. pneumoniae from Egypt. These results give new insights into the adaptation and evolution of K. pneumoniae during nosocomial infections.