Molecular characterization of carbapenem-resistant and virulent plasmids in Klebsiella pneumoniae from patients with bloodstream infections in China

Bloodstream infections (BSIs) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) are potentially life-threatening and an urgent threat to public health. The present study aims to clarify the characteristics of carbapenemase-encoding and virulent plasmids, and their interactions with the hos...

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Main Authors: Yongqiang Yang, Yanxian Yang, Guanping Chen, Minmin Lin, Yuan Chen, Ruowen He, Klibs N. Galvão, Mohamed Abd El-Gawad El-Sayed Ahmed, Adam P. Roberts, Yiping Wu, Lan-Lan Zhong, Xiaoxue Liang, Mingyang Qin, Xin Ding, Wenbin Deng, Songyin Huang, Hong-Yu Li, Min Dai, Ding-Qiang Chen, Liyan Zhang, Kang Liao, Yong Xia, Guo-Bao Tian
Format: Article
Language:English
Published: Taylor & Francis Group 2021-01-01
Series:Emerging Microbes and Infections
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Online Access:https://www.tandfonline.com/doi/10.1080/22221751.2021.1906163
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author Yongqiang Yang
Yanxian Yang
Guanping Chen
Minmin Lin
Yuan Chen
Ruowen He
Klibs N. Galvão
Mohamed Abd El-Gawad El-Sayed Ahmed
Adam P. Roberts
Yiping Wu
Lan-Lan Zhong
Xiaoxue Liang
Mingyang Qin
Xin Ding
Wenbin Deng
Songyin Huang
Hong-Yu Li
Min Dai
Ding-Qiang Chen
Liyan Zhang
Kang Liao
Yong Xia
Guo-Bao Tian
author_facet Yongqiang Yang
Yanxian Yang
Guanping Chen
Minmin Lin
Yuan Chen
Ruowen He
Klibs N. Galvão
Mohamed Abd El-Gawad El-Sayed Ahmed
Adam P. Roberts
Yiping Wu
Lan-Lan Zhong
Xiaoxue Liang
Mingyang Qin
Xin Ding
Wenbin Deng
Songyin Huang
Hong-Yu Li
Min Dai
Ding-Qiang Chen
Liyan Zhang
Kang Liao
Yong Xia
Guo-Bao Tian
author_sort Yongqiang Yang
collection DOAJ
description Bloodstream infections (BSIs) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) are potentially life-threatening and an urgent threat to public health. The present study aims to clarify the characteristics of carbapenemase-encoding and virulent plasmids, and their interactions with the host bacterium. A total of 425 Kp isolates were collected from the blood of BSI patients from nine Chinese hospitals, between 2005 and 2019. Integrated epidemiological and genomic data showed that ST11 and ST307 Kp isolates were associated with nosocomial outbreak and transmission. Comparative analysis of 147 Kp genomes and 39 completely assembled chromosomes revealed extensive interruption of acrR by ISKpn26 in all Kp carbapenemase-2 (KPC-2)-producing ST11 Kp isolates, leading to activation of the AcrAB-Tolc multidrug efflux pump and a subsequent reduction in susceptibility to the last-resort antibiotic tigecycline and six other antibiotics. We described 29 KPC-2 plasmids showing diverse structures, two virulence plasmids in two KPC-2-producing Kp, and two novel multidrug-resistant (MDR)-virulent plasmids. This study revealed a multifactorial impact of KPC-2 plasmid on Kp, which may be associated with nosocomial dissemination of MDR isolates.
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spelling doaj-art-30975a7293bb4ad4a33d4fbfcf3f13e32025-08-20T02:24:43ZengTaylor & Francis GroupEmerging Microbes and Infections2222-17512021-01-0110170070910.1080/22221751.2021.1906163Molecular characterization of carbapenem-resistant and virulent plasmids in Klebsiella pneumoniae from patients with bloodstream infections in ChinaYongqiang Yang0Yanxian Yang1Guanping Chen2Minmin Lin3Yuan Chen4Ruowen He5Klibs N. Galvão6Mohamed Abd El-Gawad El-Sayed Ahmed7Adam P. Roberts8Yiping Wu9Lan-Lan Zhong10Xiaoxue Liang11Mingyang Qin12Xin Ding13Wenbin Deng14Songyin Huang15Hong-Yu Li16Min Dai17Ding-Qiang Chen18Liyan Zhang19Kang Liao20Yong Xia21Guo-Bao Tian22Department of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, People’s Republic of ChinaDepartment of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, People’s Republic of ChinaSun Yat-sen University School of Medicine, Guangzhou, People’s Republic of ChinaDepartment of Respiratory Medicine, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, People’s Republic of ChinaSun Yat-sen University School of Medicine, Guangzhou, People’s Republic of ChinaDepartment of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, People’s Republic of ChinaDepartment of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USADepartment of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, People’s Republic of ChinaDepartment of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, UKDepartment of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, People’s Republic of ChinaDepartment of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, People’s Republic of ChinaSchool of Laboratory Medicine, Chengdu Medical College, Chengdu, People’s Republic of ChinaBasic Medical College, Xinxiang Medical University, Xinxiang, People’s Republic of ChinaSchool of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Guangzhou, People’s Republic of ChinaSchool of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Guangzhou, People’s Republic of ChinaDepartment of Clinical Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of ChinaDepartment of Clinical Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of ChinaSchool of Laboratory Medicine, Chengdu Medical College, Chengdu, People’s Republic of ChinaDivision of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of ChinaDepartment of Clinical Laboratory, Guangdong Provincial People’s Hospital / Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of ChinaDepartment of Clinical Laboratory, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People’s Republic of ChinaDepartment of Clinical Laboratory Medicine, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of ChinaDepartment of Microbiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, People’s Republic of ChinaBloodstream infections (BSIs) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) are potentially life-threatening and an urgent threat to public health. The present study aims to clarify the characteristics of carbapenemase-encoding and virulent plasmids, and their interactions with the host bacterium. A total of 425 Kp isolates were collected from the blood of BSI patients from nine Chinese hospitals, between 2005 and 2019. Integrated epidemiological and genomic data showed that ST11 and ST307 Kp isolates were associated with nosocomial outbreak and transmission. Comparative analysis of 147 Kp genomes and 39 completely assembled chromosomes revealed extensive interruption of acrR by ISKpn26 in all Kp carbapenemase-2 (KPC-2)-producing ST11 Kp isolates, leading to activation of the AcrAB-Tolc multidrug efflux pump and a subsequent reduction in susceptibility to the last-resort antibiotic tigecycline and six other antibiotics. We described 29 KPC-2 plasmids showing diverse structures, two virulence plasmids in two KPC-2-producing Kp, and two novel multidrug-resistant (MDR)-virulent plasmids. This study revealed a multifactorial impact of KPC-2 plasmid on Kp, which may be associated with nosocomial dissemination of MDR isolates.https://www.tandfonline.com/doi/10.1080/22221751.2021.1906163Bloodstream infectioncarbapenem resistanceKlebsiella pneumoniaegenomicsKPC-2
spellingShingle Yongqiang Yang
Yanxian Yang
Guanping Chen
Minmin Lin
Yuan Chen
Ruowen He
Klibs N. Galvão
Mohamed Abd El-Gawad El-Sayed Ahmed
Adam P. Roberts
Yiping Wu
Lan-Lan Zhong
Xiaoxue Liang
Mingyang Qin
Xin Ding
Wenbin Deng
Songyin Huang
Hong-Yu Li
Min Dai
Ding-Qiang Chen
Liyan Zhang
Kang Liao
Yong Xia
Guo-Bao Tian
Molecular characterization of carbapenem-resistant and virulent plasmids in Klebsiella pneumoniae from patients with bloodstream infections in China
Emerging Microbes and Infections
Bloodstream infection
carbapenem resistance
Klebsiella pneumoniae
genomics
KPC-2
title Molecular characterization of carbapenem-resistant and virulent plasmids in Klebsiella pneumoniae from patients with bloodstream infections in China
title_full Molecular characterization of carbapenem-resistant and virulent plasmids in Klebsiella pneumoniae from patients with bloodstream infections in China
title_fullStr Molecular characterization of carbapenem-resistant and virulent plasmids in Klebsiella pneumoniae from patients with bloodstream infections in China
title_full_unstemmed Molecular characterization of carbapenem-resistant and virulent plasmids in Klebsiella pneumoniae from patients with bloodstream infections in China
title_short Molecular characterization of carbapenem-resistant and virulent plasmids in Klebsiella pneumoniae from patients with bloodstream infections in China
title_sort molecular characterization of carbapenem resistant and virulent plasmids in klebsiella pneumoniae from patients with bloodstream infections in china
topic Bloodstream infection
carbapenem resistance
Klebsiella pneumoniae
genomics
KPC-2
url https://www.tandfonline.com/doi/10.1080/22221751.2021.1906163
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