Detection of a New Resistance-Mediating Plasmid Chimera in a blaOXA-48-Positive Klebsiella pneumoniae Strain at a German University Hospital

Abstract

Mobile genetic elements, such as plasmids, facilitate the spread of antibiotic resistance genes in Enterobacterales. In line with this, we investigated the plasmid-resistome of seven blaOXA-48 gene-carrying Klebsiella pneumoniae isolates, which were isolated between 2013 and 2014 at the University Medical Center in Göttingen, Germany. All isolates were subjected to complete genome sequencing including the reconstruction of entire plasmid sequences. In addition, phenotypic resistance testing was conducted. The seven isolates comprised both disease-associated isolates and colonizers isolated from five patients. They fell into two clusters of three sequence type (ST)101 and two ST11 isolates, respectively; and ST15 and ST23 singletons. The seven isolates harbored various plasmids of the incompatibility (Inc) groups IncF, IncL/M, IncN, IncR, and a novel plasmid chimera. All blaOXA-48 genes were encoded on the IncL/M plasmids. Of note, distinct phenotypical resistance patterns associated with different sets of resistance genes encoded by IncL/M and IncR plasmids were observed among isolates of the ST101 cluster in spite of high phylogenetic relatedness of the bacterial chromosomes, suggesting nosocomial transmission. This highlights the importance of plasmid uptake and plasmid recombination events for the fast generation of resistance variability after clonal transmission. In conclusion, this study contributes a piece in the puzzle of molecular epidemiology of resistance gene-carrying plasmids in K. pneumoniae in Germany.

Genomic analysis of the international high-risk clonal lineage Klebsiella pneumoniae sequence type 395

“…For the German isolate, neither the collection date nor the origin location was available. However, the German sequence has been previously described in several publications [ 84 , 98 , 99 ]. In a recent report on a K. pneumoniae ST23 outbreak in Göttingen, Germany, in 2013, it was shown, that at least one outbreak isolate seemingly carried an identical plasmid [ 98 ].…”

“…However, the German sequence has been previously described in several publications [ 84 , 98 , 99 ]. In a recent report on a K. pneumoniae ST23 outbreak in Göttingen, Germany, in 2013, it was shown, that at least one outbreak isolate seemingly carried an identical plasmid [ 98 ]. Note that the occurrence of many carbapenemase-negative genomes in multiple countries likely indicates that production of these enzymes is not the only driver of successful dissemination of ST395, however.…”

Whole Genome Sequencing of Extended-Spectrum- and AmpC- β-Lactamase-Positive Enterobacterales Isolated From Spinach Production in Gauteng Province, South Africa

“…All the S. fonticola strains also harboured numerous fluoroquinolone resistance genes, raising a health concern for treatment options, as fluoroquinolones are often used for management of conditions including typhoid fever and MDR tuberculosis (Richards et al, 2019). Interestingly, one S. fonticola strain harboured an acquired trimethoprim (sul2) resistance gene associated with IS110, corresponding to K. pneumoniae from a German university hospital (Schwanbeck et al, 2021). The Serratia genus naturally lacks resistance genes for trimethoprim and sulfonamides (Sandner-Miranda et al, 2018).…”

Editorial: Special Issue “Molecular Epidemiology of Antimicrobial Resistance”

“…The research paper by Bilal et al [ 5 ] reported the occurrence of bla NDM-1 bearing IncX3 plasmid in clinically isolated ST11 Klebsiella pneumoniae from Pakistan. A new resistance-mediating plasmid chimera was detected in bla OXA-48 -positive Klebsiella pneumoniae strain at a German university hospital [ 6 ]. HI2 plasmids mobilising the carbapenemase gene bla IMP-4 were identified both in Escherichia coli Australian clinical samples and in multiple sublineages of E. coli ST216 colonising silver gulls [ 7 ].…”