Co-occurrence of three different plasmids in an extensively drug-resistant hypervirulent Klebsiella pneumoniae isolate causing urinary tract infection
Co-occurrence of three different plasmids in an extensively drug-resistant hypervirulent Klebsiella pneumoniae isolate causing urinary tract infection
复制标题
引起尿路感染的广泛耐药性高毒力肺炎克雷伯菌分离株中三种不同质粒的共存
DOI：
10.1016/j.jgar.2020.09.002
复制
发表时间：
2020-12-01
影响因子：
4.6
通讯作者：
Jia, Xu
中科院分区：
文献类型：
--
作者：
Zhu, Xiaokui;Sun, Chuanyu;Jia, Xu
Objectives: A single carbapenem-resistant, hypervirulent Klebsiella pneumoniae strain has attracted major public concern. The aim of the present study was to better understand the antimicrobial resistance and genetic characteristics of Klebsiella pneumoniae strain XJ-K1.Methods: Klebsiella pneumoniae strain XJ-K1 was isolated from a urine specimen of a 69-year-old male patient in a teaching hospital in Shanghai, China, in January 2018. Antimicrobial susceptibility testing, string test, whole-genome sequencing, bioinformatics analysis and phylogenetic analysis were performed in this study.Results: Klebsiella pneumoniae XJ-K1 was an extensively drug-resistant (XDR) hypervirulent strain that showed high-level resistance to antibacterial agents. Three novel plasmids were discovered in strain XJ-K1, including a 207,409-bp IncHll B-type rmpA2-bearing pLVPK-like virulence plasmid, a 130,628-bp Col156/IncEIB/IncEll-type aadA2-, sul1-, mph(A)- and dfrA12-bearing MDR plasmid, and a 99,408-bp IncEll/IncR-type bla(KPC)(-2)(-), bla(TEM-1)(-),bla(CTX-M-65)(-), bla(SHV-12)(-), rmtB- and fosA3-bearing MDR plasmid. Sequence analysis of the chromosome revealed that the aadA2, fosA and sull genes were harboured by XJ-K1. Multilocus sequence typing (MSLT) showed that XJ-K1 was ST11.Conclusions: A large number of resistance genes and a pLVPK-like virulence plasmid carried by Klebsiella pneumoniae strain XJ-K1 might be the main reasons leading to the XDR and hypervirulent phenotype. To the best of our knowledge, this is the first report in China on the co-occurrence of a pLVPK-like virulence plasmid and two MDR plasmids in a single ST11 XDR and hypervirulent Klebsiella pneumoniae isolated from patient urine, which is a serious concern for its further spread. (C) 2020 The Authors. Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy.
