Coexistence of Multidrug Resistance and Virulence in a Single Conjugative Plasmid from a Hypervirulent Klebsiella pneumoniae Isolate of Sequence Type 25

作者全名："Xia, Peiwen; Yi, Miao; Yuan, Yaling; Huang, Jinzhu; Yang, Bingxue; Liao, Jiajia; Dang, Zijun; Luo, Shengli; Xia, Yun"

作者地址："[Xia, Peiwen; Yi, Miao; Yuan, Yaling; Huang, Jinzhu; Yang, Bingxue; Liao, Jiajia; Dang, Zijun; Luo, Shengli; Xia, Yun] Chongqing Med Univ, Affiliated Hosp 1, Dept Lab Med, Chongqing, Peoples R China"

通信作者："Xia, Y (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Lab Med, Chongqing, Peoples R China."

来源：MSPHERE

ESI学科分类：MICROBIOLOGY

WOS号：WOS:000893663700004

JCR分区：Q2

影响因子：4.8

年份：2022

卷号：7

期号：6

开始页：　

结束页：　

文献类型：Article

关键词：conjugative; cotransmission; bla(KPC-2); iuc operon; Klebsiella pneumoniae; ST25

摘要："The increased reporting of carbapenem-resistant hypervirulent K. pneumoniae is considered a worrisome concern to human health care and has restricted the choice of effective antibiotics for clinical treatment. Moreover, virulence plasmids with complete conjugation modules have been identified, which evolved via homologous recombination. Carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) has received considerable attention. Typically, the genetic elements that confer virulence are harbored by nonconjugative plasmids. In this study, we report a CR-hvKP strain, CY814036, of high-risk sequence type 25 (ST25) and the K2 serotype, which is uncommon among K. pneumoniae isolates but caused serious lung infection in a tertiary teaching hospital in China. Whole-genome sequencing (WGS) revealed a rare conjugative plasmid, pCY814036-iucA, carrying a virulence-associated iuc operon (iucABCD-iutA) coding for aerobactin and determinants of multidrug resistance (MDR), coexisting with a conjugative bla(KPC-2)-bearing plasmid, pCY814036-KPC2, in the same strain. A conjugation assay showed that pCY814036-iucA and pCY814036-KPC2 could be efficiently cotransmitted from CY814036 to Escherichia coli EC600. Further phenotypic investigation, including antimicrobial susceptibility tests, serum resistance assays, and mouse infection models, confirmed that pCY814036-iucA was capable of cotransferring multidrug resistance and hypervirulence features to the recipient. pCY814036-KPC2 also conferred resistance to antibiotics, including beta-lactams and aminoglycosides. Overall, the rare coexistence of a conjugative MDR-virulence plasmid and a bla(KPC-2)-bearing plasmid in a K. pneumoniae isolate offers a possible mechanism for the formation of CR-hvKP strains and the potential to significantly accelerate the propagation of high-risk phenotypes.IMPORTANCE The increased reporting of carbapenem-resistant hypervirulent K. pneumoniae is considered a worrisome concern to human health care and has restricted the choice of effective antibiotics for clinical treatment. Moreover, virulence plasmids with complete conjugation modules have been identified, which evolved via homologous recombination. Here, we characterize an ST25 CR-hvKP strain, CY814036, harboring both a conjugative MDR-virulence plasmid and a bla(KPC-2)-bearing plasmid in China. This study highlights that the cotransmission of drug resistance and virulence plasmids increases therapeutic difficulties and worsens clinical prognoses. Also, active surveillance of the conjugative MDR-virulence plasmid is necessary."

基金机构：National Natural Science Foundation of China; [X1919XYTSC]

基金资助正文："ACKNOWLEDGMENTS We extend our thanks to Shanghai Majorbio Bio-Pharm Technology Co., Ltd., for the support of whole-genome sequencing and the prediction of coding DNA sequences in the genome. This study was supported by the National Natural Science Foundation of China (no. X1919XYTSC)."