High-resolution long-read genomic analysis of plasmid-mediated multi-carbapenemase convergence in clinical Klebsiella pneumoniae: a case-series from the Middle East
Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a growing global threat, particularly in the Middle East where NDM-, KPC-, and OXA-48-producing strains are widespread.Using Oxford Nanopore long-read sequencing, four multidrug-resistant clinical isolates were analyzed, revealing:High-risk clones including ST147, ST11, and ST7518Co-existence of multiple carbapenemase genes (blaNDM, blaKPC, blaOXA-48) within the same isolatesEmergence of multi-carbapenemase hybrid strainsThe study also identified:A high abundance of mobile genetic elements, especially IS26Multiple plasmids per isolateActive horizontal gene transfer and genome rearrangement