AUTHOR=Yao Yancheng , Lazaro-Perona Fernando , Falgenhauer Linda , Valverde Aránzazu , Imirzalioglu Can , Dominguez Lucas , Cantón Rafael , Mingorance Jesús , Chakraborty Trinad 

TITLE=Insights into a Novel blaKPC-2-Encoding IncP-6 Plasmid Reveal Carbapenem-Resistance Circulation in Several Enterobacteriaceae Species from Wastewater and a Hospital Source in Spain

JOURNAL=Frontiers in Microbiology

VOLUME=8

YEAR=2017

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2017.01143

DOI=10.3389/fmicb.2017.01143

ISSN=1664-302X

ABSTRACT=<p>Untreated wastewater, particularly from hospitals and other healthcare facilities, is considered to be a reservoir for multidrug-resistant bacteria. However, its role in the spread of antibiotic resistances in the human population remains poorly investigated. We used whole genome sequencing to analyze 25 KPC-2-producing <italic>Enterobacteriaceae</italic> isolates from sewage water collected during a 3-year period and three clinical <italic>Citrobacter freundii</italic> isolates from a tertiary hospital in the same collection area in Spain. We detected a common, recently described, IncP-6 plasmid carrying the gene <italic>bla</italic><sub>KPC-2</sub> in 21 isolates from both sources. The plasmid was present in diverse environmental bacterial species of opportunistic pathogens such as <italic>C. freundii, Enterobacter cloacae, Klebsiella oxytoca</italic>, and <italic>Raoultella ornithinolytica</italic>. The 40,186 bp IncP-6 plasmid encoded 52 coding sequences and was composed of three uniquely combined regions that were derived from other plasmids recently reported in different countries of South America. The region harboring the carbapenem resistance gene (14 kb) contained a Tn<italic>3</italic> transposon disrupted by an IS<italic>Apu</italic>-flanked element and the core sequence composed by IS<italic>Kpn6</italic>/<italic>bla</italic><sub>KPC-2</sub>/Δ<italic>bla</italic><sub>TEM-1</sub>/IS<italic>Kpn27</italic>. We document here the presence of a novel promiscuous <italic>bla</italic><sub>KPC-2</sub> plasmid circulating in environmental bacteria in wastewater and human populations.</p>