Identification of Two Novel Carbapenemase-Encoding Hybrid Plasmids Harboring bla_NDM-5 and bla_KPC-2 in a Clinical ST11-KL47 Klebsiella pneumoniae

Abstract

Background

Emergence of bla_KPC and bla_NDM co-harboring Klebsiella pneumoniae has escalated the threat of Carbapenem-resistant Klebsiella pneumoniae (CRKP) to healthcare. It remains unknown the prevalence and molecular characteristics of CRKP co-producing KPC and NDMs carbapenemases in Henan.

Methods and Results

Twenty-seven CRKP strains isolated from different times were selected randomly in affiliated cancer hospital of Zhengzhou University from January 2019 to January 2021, among which one KPC-2 and NDM-5 positive CRKP named K9 was isolated from an abdominal pus sample of a 63-year-old male patient with leukemia. Sequencing of K9 determined that K9 belonged to ST11-KL47, which is resistant to antibiotics such as meropenem, ceftazidime-avibactam and tetracycline. K9 carried two different plasmids that contained bla_NDM−5 and bla_KPC−2. Both plasmids were shown to be novel hybrid plasmids and IS26 played an important role in generation of two plasmids. Gene bla_KPC-2 was flanked by the NTEKPC-Ib-like genetic structure (IS26-ΔTn3-ISKpn8-bla_KPC-2-ISKpn6-IS26) and was located on a conjugative IncFII/R/N type hybrid plasmid.

Conclusion

The resistance gene bla_NDM−5 located on a region organized as IS26-bla_NDM–5-ble-trpF-dsbD-ISCR1-sul1-aadA2-dfrA12-IntI1-IS26 was carried by a phage-plasmid. We described a clinical CRKP co-producing KPC-2 and NDM-5 and emphasized an urgent need to control their further spread.

Keywords:

• carbapenem-resistant Klebsiella pneumoniae
• KPC-2
• NDM-5
• beta-lactamases
• hybrid plasmid
• IS26

Data Sharing Statement

The datasets presented in this study can be found in online repositories. The complete chromosome genome sequence of CRKP strains K9 was deposited in GenBank with accession numbers CP074116. The complete sequences of bla_NDM-5-harboring plasmid and bla_KPC-2-harboring plasmid were submitted to GenBank under accession numbers CP074117 and CP074118, respectively.

Ethics Statement

The study protocol was approved by the Ethics Committee of Henan Cancer Hospital (NO:2022-KY-0036). The patients/participants provided their written informed consent to participate in this study. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study was supported by the Joint Construction Project of the Henan Provincial Health Commission (Grant No. LHGJ20210218, LHGJ20220209, SBGJ202102070).