title: Coexistence ofblaOXA-48and TruncatedblaNDM-1on Different Plasmids in aKlebsiella pneumoniaeIsolate in China.
abstract: Objectives:To describe the genetic environment, transferability, and antibiotic susceptibility of one clinicalKlebsiella pneumoniaeisolate harboring bothblaOXA-48andblaNDM-1on different plasmids from a Chinese hospital.Methods:The isolate was subjected to antimicrobial susceptibility testing and multilocus sequence typing using Etest and PCR. The plasmids harboringblaOXA-48andblaNDM-1were analyzed through conjugation experiments, S1-nuclease pulsed-field gel electrophoresis, and hybridization with specific probes. Plasmid DNA was sequenced using Pacbio RS II and annotated using RAST.Results:K. pneumoniaeRJ119, carrying bothblaOXA-48andblaNDM-1, was resistant to almost all carbapenems, cephalosporins, fluoroquinolone, and aminoglycosides and belonged to ST307.blaOXA-48was located on a 61,748-bp IncL/M conjugative plasmid, which displayed overall nucleotide identity (99%) to pKPN-E1-Nr.7.blaNDM-1was located on a 335,317-bp conjugative plasmid, which was a fusion of ablaNDM-1-harboring InA/C plasmid pNDM-US (140,825 bp, 99% identity) and an IncFIB plasmid pKPN-c22 (178,563 bp, 99% identity). The transconjugant RJ119-1 harboringblaNDM-1was susceptible to carbapenem, and there was an insertion of IS10into theblaNDM-1gene.Conclusion:This is the first report of the coexistence ofblaOXA-48andblaNDM-1in oneK. pneumoniaeclinical isolate in China. OXA-48 in RJ119 contributed to the majority to its high resistance to carbapenems, whereas NDM-1 remained unexpressed, most likely due to the insertion of IS10. Our results provide new insight for the relationship between genetic diagnosis and clinical treatment. They also indicate that increased surveillance ofblaOXA-48is urgently needed in China.
authors.affiliation: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine Shanghai, China.
authors.forename: Lianyan
authors.initials: L
authors.lastname: Xie
authors.affiliation: Department of Burns and Plastic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine Shanghai, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Dou
authors.affiliation: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine Shanghai, China.
authors.forename: Kaixin
authors.initials: K
authors.lastname: Zhou
authors.affiliation: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine Shanghai, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine Shanghai, China.
authors.forename: Lizhong
authors.initials: L
authors.lastname: Han
authors.affiliation: Department of Medical Microbiology and Parasitology, Institutes of Medical Sciences, Shanghai Jiaotong University School of Medicine Shanghai, China.
authors.forename: Xiaokui
authors.initials: X
authors.lastname: Guo
authors.affiliation: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine Shanghai, China.
authors.forename: Jingyong
authors.initials: J
authors.lastname: Sun
keywords: NDM-1; OXA-48; carbapenemase; coexistence; plasmid