Coexistence of bla NDM-1, mcr-1 and bla CTX-M-199 in an ST499 multidrug resistant Klebsiella pneumoniae Isolate

Abstract The coexistence of multiple resistance genes within a single bacterial strain presents a significant public health challenge, as it complicates treatment options and accelerates the spread of multidrug resistance. While the co-occurrence of bla NDM-1 and mcr-1 genes in Klebsiella pneumoniae...

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Main Authors: Xinjun Hu, Bingyou Yin, Ruishan Liu, Lu Gong, Xiaolu Yang, Zhenghao Lou, Haowei Ye, Bingyang Shang, Yibing Shang, Yingjian Zhang
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-03759-1
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author Xinjun Hu
Bingyou Yin
Ruishan Liu
Lu Gong
Xiaolu Yang
Zhenghao Lou
Haowei Ye
Bingyang Shang
Yibing Shang
Yingjian Zhang
author_facet Xinjun Hu
Bingyou Yin
Ruishan Liu
Lu Gong
Xiaolu Yang
Zhenghao Lou
Haowei Ye
Bingyang Shang
Yibing Shang
Yingjian Zhang
author_sort Xinjun Hu
collection DOAJ
description Abstract The coexistence of multiple resistance genes within a single bacterial strain presents a significant public health challenge, as it complicates treatment options and accelerates the spread of multidrug resistance. While the co-occurrence of bla NDM-1 and mcr-1 genes in Klebsiella pneumoniae (KP) is uncommon, this study reports the biological characterization of a K. pneumoniae isolate, L5151, derived from a patient with diarrhea. This strain carries bla NDM-1, mcr-1, and bla CTX-M-199 resistance genes simultaneously. Multilocus sequence typing (MLST) analysis identified the L5151 strain as an ST499 type. Antimicrobial susceptibility testing (AST) was conducted via agar dilution and the broth microdilution procedure. The AST results revealed that L5151 is resistant to a variety of antibiotics. Whole-genome sequencing (WGS) and bioinformatics analysis were performed to determine the genetic composition of the strain, including the presence and characteristics of resistance genes. The results of S1 nuclease-pulsed field gel electrophoresis (S1-PFGE) and Southern blotting confirmed that the L5151 strain harbors three plasmids and that the plasmid carrying mcr-1 (pL5151_MCR_CTX) is of the IncI2(Delta) type, whereas the plasmid carrying bla NDM-1 (pL5151_NDM) is of the IncN type. The combination of these plasmids in recipient strains conferred enhanced resistance to carbapenems and colistin, highlighting the potential for increased treatment challenges. This study emphasizes the importance of ongoing surveillance of multidrug-resistant strains to prevent their spread and outbreaks. These findings provide critical insights for clinical treatment strategies and infection prevention and control measures. Enhanced surveillance and targeted interventions are essential to manage the public health risks posed by multidrug-resistant strains.
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spelling doaj-art-e31b1a845ea348e4aa4323b7c3925ddc2025-08-20T04:01:41ZengNature PortfolioScientific Reports2045-23222025-05-011511710.1038/s41598-025-03759-1Coexistence of bla NDM-1, mcr-1 and bla CTX-M-199 in an ST499 multidrug resistant Klebsiella pneumoniae IsolateXinjun Hu0Bingyou Yin1Ruishan Liu2Lu Gong3Xiaolu Yang4Zhenghao Lou5Haowei Ye6Bingyang Shang7Yibing Shang8Yingjian Zhang9Department of Infectious Diseases, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and TechnologyDepartment of Infectious Diseases, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and TechnologyCollaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of MedicineSchool of Basic Medical Sciences, Zhejiang Chinese Medical UniversitySchool of Basic Medical Sciences, Zhejiang Chinese Medical UniversitySchool of Basic Medical Sciences, Zhejiang Chinese Medical UniversityCollaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Infectious Diseases, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and TechnologyDepartment of Infectious Diseases, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and TechnologyHenan Medical Key Laboratory of Gastrointestinal Microecology and HepatologyAbstract The coexistence of multiple resistance genes within a single bacterial strain presents a significant public health challenge, as it complicates treatment options and accelerates the spread of multidrug resistance. While the co-occurrence of bla NDM-1 and mcr-1 genes in Klebsiella pneumoniae (KP) is uncommon, this study reports the biological characterization of a K. pneumoniae isolate, L5151, derived from a patient with diarrhea. This strain carries bla NDM-1, mcr-1, and bla CTX-M-199 resistance genes simultaneously. Multilocus sequence typing (MLST) analysis identified the L5151 strain as an ST499 type. Antimicrobial susceptibility testing (AST) was conducted via agar dilution and the broth microdilution procedure. The AST results revealed that L5151 is resistant to a variety of antibiotics. Whole-genome sequencing (WGS) and bioinformatics analysis were performed to determine the genetic composition of the strain, including the presence and characteristics of resistance genes. The results of S1 nuclease-pulsed field gel electrophoresis (S1-PFGE) and Southern blotting confirmed that the L5151 strain harbors three plasmids and that the plasmid carrying mcr-1 (pL5151_MCR_CTX) is of the IncI2(Delta) type, whereas the plasmid carrying bla NDM-1 (pL5151_NDM) is of the IncN type. The combination of these plasmids in recipient strains conferred enhanced resistance to carbapenems and colistin, highlighting the potential for increased treatment challenges. This study emphasizes the importance of ongoing surveillance of multidrug-resistant strains to prevent their spread and outbreaks. These findings provide critical insights for clinical treatment strategies and infection prevention and control measures. Enhanced surveillance and targeted interventions are essential to manage the public health risks posed by multidrug-resistant strains.https://doi.org/10.1038/s41598-025-03759-1Klebsiella pneumoniaeMultidrug resistanceMCR-1bla NDM-1bla CTX-M-199Whole genome sequencing
spellingShingle Xinjun Hu
Bingyou Yin
Ruishan Liu
Lu Gong
Xiaolu Yang
Zhenghao Lou
Haowei Ye
Bingyang Shang
Yibing Shang
Yingjian Zhang
Coexistence of bla NDM-1, mcr-1 and bla CTX-M-199 in an ST499 multidrug resistant Klebsiella pneumoniae Isolate
Scientific Reports
Klebsiella pneumoniae
Multidrug resistance
MCR-1
bla NDM-1
bla CTX-M-199
Whole genome sequencing
title Coexistence of bla NDM-1, mcr-1 and bla CTX-M-199 in an ST499 multidrug resistant Klebsiella pneumoniae Isolate
title_full Coexistence of bla NDM-1, mcr-1 and bla CTX-M-199 in an ST499 multidrug resistant Klebsiella pneumoniae Isolate
title_fullStr Coexistence of bla NDM-1, mcr-1 and bla CTX-M-199 in an ST499 multidrug resistant Klebsiella pneumoniae Isolate
title_full_unstemmed Coexistence of bla NDM-1, mcr-1 and bla CTX-M-199 in an ST499 multidrug resistant Klebsiella pneumoniae Isolate
title_short Coexistence of bla NDM-1, mcr-1 and bla CTX-M-199 in an ST499 multidrug resistant Klebsiella pneumoniae Isolate
title_sort coexistence of bla ndm 1 mcr 1 and bla ctx m 199 in an st499 multidrug resistant klebsiella pneumoniae isolate
topic Klebsiella pneumoniae
Multidrug resistance
MCR-1
bla NDM-1
bla CTX-M-199
Whole genome sequencing
url https://doi.org/10.1038/s41598-025-03759-1
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