A Cluster of Colistin- and Carbapenem-Resistant Klebsiella pneumoniae Carrying blaNDM-1 and mcr-8.2

Author:

Ma Ke123,Feng Yu123ORCID,Liu Lu123,Yao Zhihong123,Zong Zhiyong1234

Affiliation:

1. Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China

2. Division of Infectious Diseases, State Key Laboratory of Biotherapy, Chengdu, China

3. Center for Pathogen Research, West China Hospital, Sichuan University, Chengdu, China

4. Department of Infection Control, West China Hospital, Sichuan University, Chengdu, China

Abstract

Abstract Background Klebsiella pneumoniae resistant to both carbapenems and colistin imposes severe challenges for management. In this study, we report a cluster of 5 carbapenem-resistant K pneumoniae clinical strains belonging to ST1 and K57 types, 4 of which were also resistant to colistin, from 2 hospitals. Methods The 5 strains were subjected to whole-genome sequencing (WGS) using the short-read Illumina HiSeq platform, and 2 strains were also selected for long-read WGS using MinION. Clonal relatedness of the 5 strains was determined based on single-nucleotide polymorphisms (SNPs). Conjugation experiments were performed to obtain self-transmissible plasmids. Results All 5 strains carried the carbapenemase-encoding gene blaNDM-1, whereas the 4 colistin-resistant strains also harbored a new variant of the mcr-8 colistin resistance gene, namely, mcr-8.2. MCR-8.2 differs from MCR-8.1 by four amino acid substitutions (A51V, A232S, N365Y, and N480K). mcr-8.2 was located on a large, hybrid, nonself-transmissible plasmid containing IncQ, IncR, and IncFII replicons, whereas blaNDM-1 was carried by self-transmissible IncX3 plasmids. Phylogenetic analysis based on SNPs revealed that the 5 strains were likely to have a common origin. Conclusions Both the intra- and interhospital transfer of strains carrying mcr-8 and blaNDM-1 were identified, which represents an emerging threat for clinical management and infection control.

Funder

National Natural Science Foundation of China

Newton Advanced Fellowship, Royal Society, UK

West China Hospital of Sichuan University

Ministry of Science, China

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Immunology and Allergy

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