Characterisation of blaNDM-5 and blaKPC-2 co-occurrence in K64-ST11 carbapenem-resistant Klebsiella pneumoniae

Comparison of Two Distinct Subpopulations of Klebsiella pneumoniae ST16 Co-Occurring in a Single Patient

“…In addition, multiple insertion sequence elements were found scattered throughout pOXA1-191663, which may facilitate the dissemination of the antimicrobial resistance determinants. Last year, we reported KPC-2 and NDM-5 co-producing CRKP ST11 isolated from a clinical patient in Wuxi, China ( 11 ), and subsequently, Xi Li et al identified the MBL double-positive ( bla VIM-4 and bla NDM-1 ) plasmid in Klebsiella michiganensis ( 46 ). These researchers of two carbapenem-resistant genes carried by the same strain increase the awareness of carbapenem-resistant Enterobacteriaceae .…”

“…At the same time, OXA-181, sharing the similar penicillin and carbapenem hydrolytic activity with OXA-48, was associated with nosocomial outbreak by conjugative plasmid IncX3 in Ghana recently ( 10 ). The coexistence of two classes of carbapenemases has been detected globally, which could intensify substantial challenges for treatment ( 6 , 7 , 11 ). In this study, we characterized two distinct lineages of K. pneumoniae ST16 from the same patient.…”

Clinical and Molecular Characterizations of Carbapenem-Resistant Klebsiella pneumoniae Causing Bloodstream Infection in a Chinese Hospital

“…Sequence blasting found that 5 strains carrying bla KPC-2 and bla NDM-5 genes were encoded in the different plasmids, 1 strain named KPN11 carrying bla KPC-2 was encoded in plasmid and bla NDM-5 was encoded in the chromosome. Previous studies had reported that one strain carried both bla NDM-5 and bla KPC-2 ( 36 ), but they were from different plasmids compared with these 6 strains. We guess that there had been abacterial conjugation which leads to the combination of bla KPC-2 and bla NDM-5 genes into a plasmid.…”

Carbapenem antibiotic stress increases blaKPC‐2 gene relative copy number and bacterial resistance levels of Klebsiella pneumoniae

“…Compared to CR-KP isolates grown on LB plates, not all nine isolates exhibited elevated carbapenem resistance, only five CR-KP isolates exhibited elevated MICs to imipenem, from 32 μg/ml to 64 μg/ml or 64 μg/ml to 128 μg/ml, while the other four exhibited unchanged MICs to imipenem. Due to the methodological shortcomings of the broth microdilution method itself, with a large inter-well span, we were unable to obtain exact MIC values, but it is not difficult for us to find that moderate antibiotic pressure can increase the MIC levels of CR-KP to imipenem, and this also suggests that KPC enzymes alone are not always sufficient to confer carbapenem resistance, but that multiple resistance mechanisms coexist (production of carbapenem hydrolases, [38][39][40] reduction of carbapenem membrane permeability, 41 loss of bacterial channel proteins, 42 overexpression of bacterial active efflux systems, 43 etc.). For example, the copy number of strain 5 in this study was relatively low, but its drug resistance level reached 256 μg/ml.…”