ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.

Sec. Molecular Bacterial Pathogenesis

Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1564277

This article is part of the Research TopicCarbapenem-Resistant Enterobacteriaceae: Microbiome Influence and Infectious Disease DynamicsView all articles

Emergence and characterization of a ST852 Klebsiella quasipneumoniae clinical isolate coharboring bla NDM-1 and bla KPC-2 in China

Provisionally accepted
Chongmei  TianChongmei Tian1Yaping  ZhaoYaping Zhao1Su  DongSu Dong2Zhixin  YouZhixin You2Jingbai  ChenJingbai Chen2Hongfeng  XuHongfeng Xu2Yuejuan  FangYuejuan Fang2Yapei  ZhangYapei Zhang3*
  • 1Department of Pharmacy, Shaoxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Shaoxing, China
  • 2Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing, Zhejiang Province, China
  • 3Zhejiang Hospital, Hangzhou, Zhejiang Province, China

The final, formatted version of the article will be published soon.

Objectives: To characterize a rare ST852 Klebsiella quasipneumoniae strain co-producing NDM-1 and KPC-2 isolated from a clinical patient.Methods: Minimum inhibitory concentrations (MICs) were measured using a VITEK 2 compact system and broth microdilution. Conjugation experiments were conducted using film matings. Whole genome sequencing (WGS) was performed using Illumina and Nanopore platforms. Antimicrobial resistance determinants were identified using the ABRicate program in the ResFinder database. Insertion sequences (ISs) were identified using ISFinder. Bacterial virulence factors were identified using a virulence factor database (VFDB). Genome function annotation and classification were further analyzed using the Kyoto Encyclopedia of Genes and Genomes (KEGG) and Cluster of Orthologous Groups (COG) databases. Capsular polysaccharides (KL) and lipooligosaccharides (OCL) were tested using Kleborate with the Kaptive. Multilocus sequence typing (MLST) and replicon types were identified using the Center for Genomic Epidemiology website. Prophage region analysis was performed using PHASTEST software. Conjugation-related elements were predicted using oriTfinder. The plasmid structure was visualized using Circos and similar plasmids in the public database were tracked using BacWGSTdb. A global phylogeny for the ST852 K. quasipneumoniae isolates was further performed.Results: K. quasipneumoniae KPSY isolate was identified as ST852, with KL18 and O3/O3a. It has an extensive drug-resistant (XDR) profile. WGS analysis revealed that it contained one circular chromosome and three plasmids. The results of the COG and KEGG functional classifications showed that most of the functions were associated with metabolism. pKPSY-2 is a 239,226-bp IncU plasmid carrying the carbapenem resistance gene blaNDM-1. pKPSY-3 is a smaller plasmid belonging to the IncN-type conjugative plasmid with blaKPC-2. Importantly, oriT sequence, the T4SS region, T4CP, and relaxase were identified. Tracking of the blaKPC-2 plasmids showed they were identified in different species in different countries, including E. coli, Leclercia sp., Pantoea sp., and E. hormaechei. Global analysis data showed 13 ST852 strains were mainly isolated from China (84.62%, 11/13), and the remaining isolates were collected from Switzerland.Conclusions: This is the first study to identify an ST852 NDM-1-KPC-2 coproducing K. quasipneumoniae clinical isolate. Surveillance is warranted, and early detection of this high-risk clone in the clinic is recommended to avoid its extensive spread.

Keywords: K. quasipneumoniae, WGS, ST852, NDM-1, KPC-2, Plasmid structure

Received: 21 Jan 2025; Accepted: 21 Apr 2025.

Copyright: © 2025 Tian, Zhao, Dong, You, Chen, Xu, Fang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Yapei Zhang, Zhejiang Hospital, Hangzhou, 310013, Zhejiang Province, China

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