Small IncQ1 and Col-Like Plasmids Harboring
 bla
 KPC-2
 and Non-Tn
 4401
 Elements (NTE
 KPC
 -IId) in High-Risk Lineages of
 Klebsiella pneumoniae
 CG258

Cerdeira, Louise; Lam, Margaret M C; Wyres, Kelly L.; Wick, Ryan R.; Judd, Louise M.; Lopes, Ralf; Ribas, Rosineide Marques; Morais, Márcia Maria Camargo de; Holt, Kathryn E.; Lincopán, Nilton

doi:10.1128/aac.02140-18

Cited by 29 publications

(21 citation statements)

References 15 publications

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“…Over the last 5-year period, IncQ1 plasmids carrying bla KPC-2 have been reported in several different pathogens in Brazil including Klebsiella quasipneumoniae (1 isolate, BSI), K. pneumoniae ST340 (CC258) (1 isolate, no clinical data), and Pseudomonas aeruginosa ST2584 (1 isolate, BSI), as shown in Fig. 3 ( 29 – 31 ). This current outbreak added a further six additional cases and suggests that IncQ1 plasmids can act as efficient bla KPC-2 carriers.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Molecular Description of a High-Copy IncQ1 KPC-2 Plasmid Harbored by the International ST15 Klebsiella pneumoniae Clone

Martins

Nicolás

et al. 2020

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This study provides the genomic characterization and clinical description of bloodstream infections (BSI) cases due to ST15 KPC-2 producer Klebsiella pneumoniae. Six KPC-K. pneumoniae isolates were recovered in 2015 in a tertiary Brazilian hospital and were analyzed by whole-genome sequencing (WGS) (Illumina MiSeq short reads). Of these, two isolates were further analyzed by Nanopore MinION sequencing, allowing complete chromosome and plasmid circularization (hybrid assembly), using Unicycler software. The clinical analysis showed that the 30-day overall mortality for these BSI cases was high (83%). The isolates exhibited meropenem resistance (MICs, 32 to 128 mg/liter), with 3/6 isolates resistant to polymyxin B. The conjugative properties of the blaKPC-2 plasmid and its copy number were assessed by standard conjugation experiments and sequence copy number analysis. We identified in all six isolates a small (8.3-kb), high-copy-number (20 copies/cell) non-self-conjugative IncQ plasmid harboring blaKPC-2 in a non-Tn4401 transposon. This plasmid backbone was previously reported to harbor blaKPC-2 only in Brazil, and it could be comobilized at a high frequency (10−4) into Escherichia coli J53 and into several high-risk K. pneumoniae clones (ST258, ST15, and ST101) by a common IncL/M helper plasmid, suggesting the potential of international spread. This study thus identified the international K. pneumoniae ST15 clone as a carrier of blaKPC-2 in a high-copy-number IncQ1 plasmid that is easily transmissible among other common Klebsiella strains. This finding is of concern since IncQ1 plasmids are efficient antimicrobial resistance determinant carriers across Gram-negative species. The spread of such carbapenemase-encoding IncQ1 plasmids should therefore be closely monitored. IMPORTANCE In many parts of the world, carbapenem resistance is a serious public health concern. In Brazil, carbapenem resistance in Enterobacterales is mostly driven by the dissemination of KPC-2-producing K. pneumoniae clones. Despite being endemic in this country, only a few reports providing both clinical and genomic data are available in Brazil, which limit the understanding of the real clinical impact caused by the dissemination of different clones carrying blaKPC-2 in Brazilian hospitals. Although several of these KPC-2-producer K. pneumoniae isolates belong to the clonal complex 258 and carry Tn4401 transposons located on large plasmids, a concomitant emergence and silent dissemination of small high-copy-number blaKPC-2 plasmids are of importance, as described in this study. Our data identify a small high-copy-number IncQ1 KPC plasmid, its clinical relevance, and the potential for conjugative transfer into several K. pneumoniae isolates, belonging to different international lineages, such as ST258, ST101, and ST15.

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Section: Discussionmentioning

confidence: 99%

Clinical and Molecular Description of a High-Copy IncQ1 KPC-2 Plasmid Harbored by the International ST15 Klebsiella pneumoniae Clone

Martins

Nicolás

et al. 2020

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“…Nicoletti et al (2015) 41 identified the bla KPC gene inserted into an IncQ plasmid in K. pneumoniae. Cerdeira et al (2019) 16 detected two isolates of K. pneumoniae that were resistant to carbapenems and had the bla KPC gene inserted into IncQ plasmids. According to Smalla et al (2000) 27 , IncQ is a small plasmid that can vary between 5.1-14.2 kb in size, and it can be found in several host bacterial cells.…”

Section: /8mentioning

confidence: 99%

“…Klebsiella pneumoniae carbapenemase (KPC) has become endemic in several countries and is frequently detected in K. pneumoniae isolates from Brazilian hospitals 1 , 13 , 14 , 15 , 16 , 17 . The bla KPC gene is often located on the transposon Tn4401 (Eilertson et al 18 ), which has been found in several transferable plasmids 4 , 19 , 20 , which ensures its dispersion among Klebsiella species and other genera of Gram-negative bacteria (Belder et al 21 ).…”

Section: Introductionmentioning

confidence: 99%

“…The bla KPC gene is often located on the transposon Tn4401 (Eilertson et al 18 ), which has been found in several transferable plasmids 4 , 19 , 20 , which ensures its dispersion among Klebsiella species and other genera of Gram-negative bacteria (Belder et al 21 ). The bla KPC gene can also be found in non-Tn4401 elements (NTE KPC ) 16 , 22 .…”

Section: Introductionmentioning

confidence: 99%

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High plasmid variability, and the presence of IncFIB, IncQ, IncA/C, IncHI1B, and IncL/M in clinical isolates of Klebsiella pneumoniae with bla KPC and bla NDM from patients at a public hospital in Brazil.

Oliveira

Beltrão

Scavuzzi

et al. 2020

Rev. Soc. Bras. Med. Trop.

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Introduction: Antibiotic resistance in carbapenemase-producing Klebsiella pneumoniae is acquired and disseminated mainly by plasmids. Therefore, we aimed to investigate the occurrence of carbapenemase genes, analyze the genetic diversity by ERIC-PCR, and examine the most common plasmid incompatibility groups (Incs) in clinical isolates of K. pneumoniae from colonization and infection in patients from a hospital in Brazil. Methods: Twenty-seven isolates of carbapenem-resistant K. pneumoniae were selected and screened for the presence of carbapenemase genes and Incs by PCR, followed by amplicon sequencing. Results: The bla KPC and bla NDM genes were detected in 24 (88.8 %) and 16 (59.2 %) of the isolates, respectively. Thirteen isolates (48.1 %) were positive for both genes. The IncFIB (92.6 %) and IncQ (88.8 %) were the most frequent plasmids, followed by IncA/C, IncHI1B, and IncL/M, indicating that plasmid variability existed in these isolates. To our knowledge, this is the first report of IncHI1B in Brazil. We found eight isolates with clonal relationship distributed in different sectors of the hospital. Conclusions: The accumulation of resistance determinants, the variability of plasmid Incs, and the clonal dissemination detected in K. pneumoniae isolates demonstrate their potential for infection, colonization, and the dissemination of different resistance genes and plasmids.

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“…International genetic contexts of bla CTX-M-14 (ISEcp1-bla CTX-M-14 -IS903D) (Lartigue, Poirel, & Nordmann, 2004) Regarding other plasmids identified in this study, IncN and IncHI2 have been related to the spread of bla CTX-M-1 and bla CTX-M-9 , respectively, and IncQ1 or IncX plasmid has been responsible by dissemination of carbapenemase encoding genes (Cerdeira et al, 2019;Mollenkopf et al, 2017;Paul et al, 2017;Zhao & Hu, 2013).…”

Section: Re Sults and Discussionmentioning

confidence: 80%

International clones of extended‐spectrum β‐lactamase (CTX‐M)‐producingEscherichia coliin peri‐urban wild animals, Brazil

Carvalho

Fernandes

Sellera

et al. 2020

Transbound Emerg Dis

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CTX‐M‐type extended‐spectrum β‐lactamase (ESBL)‐producing Escherichia coli clones have been increasingly reported worldwide. In this regard, although discussions of transmission routes of these bacteria are in evidence, molecular data are lacking to elucidate the epidemiological impacts of ESBL producers in wild animals. In this study, we have screened 90 wild animals living in a surrounding area of São Paulo, the largest metropolitan city in South America, to monitor the presence of multidrug‐resistant (MDR) Gram‐negative bacteria. Using a genomic approach, we have analysed eight ceftriaxone‐resistant E. coli. Resistome analyses revealed that all E. coli strains carried blaCTX‐M‐type genes, prevalent in human infections, besides other clinically relevant resistance genes to aminoglycosides, β‐lactams, phenicols, tetracyclines, sulphonamides, trimethoprim, fosfomycin and quinolones. Additionally, E. coli strains belonged to international sequence types (STs) ST38, ST58, ST212, ST744, ST1158 and ST1251, and carried several virulence‐associated genes. Our findings suggest spread and adaptation of international clones of CTX‐M‐producing E. coli beyond urban settings, including wildlife from shared environments.

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Small IncQ1 and Col-Like Plasmids Harboring bla _KPC-2 and Non-Tn 4401 Elements (NTE _KPC -IId) in High-Risk Lineages of Klebsiella pneumoniae CG258

Abstract: Col-like plasmids harboring bla KPC-2 and non-Tn4401 elements (NTE KPC-IId) in high-risk lineages of Klebsiella pneumoniae CG258.

Cited by 29 publications

References 15 publications

Clinical and Molecular Description of a High-Copy IncQ1 KPC-2 Plasmid Harbored by the International ST15 Klebsiella pneumoniae Clone

Clinical and Molecular Description of a High-Copy IncQ1 KPC-2 Plasmid Harbored by the International ST15 Klebsiella pneumoniae Clone

High plasmid variability, and the presence of IncFIB, IncQ, IncA/C, IncHI1B, and IncL/M in clinical isolates of Klebsiella pneumoniae with bla KPC and bla NDM from patients at a public hospital in Brazil.

International clones of extended‐spectrum β‐lactamase (CTX‐M)‐producingEscherichia coliin peri‐urban wild animals, Brazil

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Small IncQ1 and Col-Like Plasmids Harboring bla KPC-2 and Non-Tn 4401 Elements (NTE KPC -IId) in High-Risk Lineages of Klebsiella pneumoniae CG258

Abstract: Col-like plasmids harboring bla KPC-2 and non-Tn4401 elements (NTE KPC-IId) in high-risk lineages of Klebsiella pneumoniae CG258.

Cited by 29 publications

References 15 publications

Clinical and Molecular Description of a High-Copy IncQ1 KPC-2 Plasmid Harbored by the International ST15 Klebsiella pneumoniae Clone

Clinical and Molecular Description of a High-Copy IncQ1 KPC-2 Plasmid Harbored by the International ST15 Klebsiella pneumoniae Clone

High plasmid variability, and the presence of IncFIB, IncQ, IncA/C, IncHI1B, and IncL/M in clinical isolates of Klebsiella pneumoniae with bla KPC and bla NDM from patients at a public hospital in Brazil.

International clones of extended‐spectrum β‐lactamase (CTX‐M)‐producingEscherichia coliin peri‐urban wild animals, Brazil

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Small IncQ1 and Col-Like Plasmids Harboring bla _KPC-2 and Non-Tn 4401 Elements (NTE _KPC -IId) in High-Risk Lineages of Klebsiella pneumoniae CG258