Coexistence of bla and bla in an IncHI5B plasmid harbored by tigecycline-non-susceptible Klebsiella variicola strain.

Hui Chen, Hao Xu, Ruishan Liu, Jian Shen, Beiwen Zheng, Lanjuan Li
Author Information
  1. Hui Chen: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd, Hangzhou City, 310003, China.
  2. Hao Xu: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd, Hangzhou City, 310003, China.
  3. Ruishan Liu: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd, Hangzhou City, 310003, China.
  4. Jian Shen: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd, Hangzhou City, 310003, China.
  5. Beiwen Zheng: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd, Hangzhou City, 310003, China. zhengbw@zju.edu.cn.
  6. Lanjuan Li: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Rd, Hangzhou City, 310003, China. ljli@zju.edu.cn.

Abstract

BACKGROUND: Klebsiella variicola is considered a newly emerging human pathogen. Clinical isolates of carbapenemase and broad-spectrum β-lactamase-producing K. variicola remain relatively uncommon. A strain of K. variicola 4253 was isolated from a clinical sample, and was identified to carry the bla and bla genes. This study aims to discern its antibiotic resistance phenotype and genomic characteristics.
METHODS: Species identification was conducted using MALDI-TOF/MS. PCR identification confirmed the presence of the bla and bla genes. Antibiotic resistance phenotype and genomic characteristics were detected by antimicrobial susceptibility testing and whole-genome sequencing. Plasmid characterization was carried out through S1-PFGE, conjugation experiments, Southern blot, and comparative genomic analysis.
RESULTS: K. variicola 4253 belonged to ST347, and demonstrated resistance to broad-spectrum β-lactamase drugs and tigecycline while being insensitive to imipenem and meropenem. The bla and bla genes harbored on the plasmid p4253-imp. The replicon type of p4253-imp was identified as IncHI5B, representing a multidrug-resistant plasmid capable of horizontal transfer and mediating the dissemination of drug resistance. The bla gene was located on the In809-like integrative element (Intl1-bla-aacA4-catB3), which circulates in Acinetobacter and Enterobacteriaceae.
CONCLUSIONS: This study reports the presence of a strain of K. variicola, which is insensitive to tigecycline, carrying a plasmid harboring bla and bla. It is highly likely that the strain acquired this plasmid through horizontal transfer. The bla array (Intl1-bla-aacA4-catB3) is also mobile in Acinetobacter and Enterobacteriaceae. So it is essential to enhance clinical awareness and conduct epidemiological surveillance on multidrug-resistant K. variicola, conjugative plasmids carrying bla, and the In809 integrative element.

Keywords

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Grants

  1. 2022ZFJH003/the Fundamental Research Funds for the Central Universities
  2. 2022ZFJH003/the Fundamental Research Funds for the Central Universities
  3. SYS202202/Shandong Provincial Laboratory Project
  4. SYS202202/Shandong Provincial Laboratory Project
  5. JNL-2022001A/Research Project of Jinan Microecological Biomedicine Shandong Laboratory
  6. JNL-2022001A/Research Project of Jinan Microecological Biomedicine Shandong Laboratory

MeSH Term

Humans
Tigecycline
Klebsiella
Acinetobacter
Plasmids
beta-Lactamases

Chemicals

Tigecycline
beta-Lactamases

Word Cloud

Created with Highcharts 10.0.0blavariicolaKplasmidstrainresistanceKlebsiellagenesgenomicIncHI5Bbroad-spectrum4253clinicalidentifiedstudyphenotypecharacteristicsidentificationpresencetigecyclineinsensitiveharboredp4253-impmultidrug-resistanthorizontaltransferintegrativeelementIntl1-bla-aacA4-catB3AcinetobacterEnterobacteriaceaecarryingIn809BACKGROUND:considerednewlyemerginghumanpathogenClinicalisolatescarbapenemaseβ-lactamase-producingremainrelativelyuncommonisolatedsamplecarryaimsdiscernantibioticMETHODS:SpeciesconductedusingMALDI-TOF/MSPCRconfirmedAntibioticdetectedantimicrobialsusceptibilitytestingwhole-genomesequencingPlasmidcharacterizationcarriedS1-PFGEconjugationexperimentsSouthernblotcomparativeanalysisRESULTS:belongedST347demonstratedβ-lactamasedrugsimipenemmeropenemreplicontyperepresentingcapablemediatingdisseminationdruggenelocatedIn809-likecirculatesCONCLUSIONS:reportsharboringhighlylikelyacquiredarrayalsomobileessentialenhanceawarenessconductepidemiologicalsurveillanceconjugativeplasmidsCoexistencetigecycline-non-susceptibleIMP−4Tigecycline

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