AUTHOR=Prussing Catharine , Snavely Emily A. , Singh Navjot , Lapierre Pascal , Lasek-Nesselquist Erica , Mitchell Kara , Haas Wolfgang , Owsiak Rita , Nazarian Elizabeth , Musser Kimberlee A. 

TITLE=Nanopore MinION Sequencing Reveals Possible Transfer of blaKPC–2 Plasmid Across Bacterial Species in Two Healthcare Facilities

JOURNAL=Frontiers in Microbiology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2020.02007

DOI=10.3389/fmicb.2020.02007

ISSN=1664-302X

ABSTRACT=<p>Carbapenemase-producing <italic>Enterobacteriaceae</italic> are a major threat to global public health. <italic>Klebsiella pneumoniae</italic> carbapenemase (KPC) is the most commonly identified carbapenemase in the United States and is frequently found on mobile genetic elements including plasmids, which can be horizontally transmitted between bacteria of the same or different species. Here we describe the results of an epidemiological investigation of KPC-producing bacteria at two healthcare facilities. Using a combination of short-read and long-read whole-genome sequencing, we identified an identical 44 kilobase plasmid carrying the <italic>bla</italic><sub>KPC–2</sub> gene in four bacterial isolates belonging to three different species (<italic>Citrobacter freundii</italic>, <italic>Klebsiella pneumoniae</italic>, and <italic>Escherichia coli</italic>). The isolates in this investigation were collected from patients who were epidemiologically linked in a region in which KPC was uncommon, suggesting that the antibiotic resistance plasmid was transmitted between these bacterial species. This investigation highlights the importance of long-read sequencing in investigating the relatedness of bacterial plasmids, and in elucidating potential plasmid-mediated outbreaks caused by antibiotic resistant bacteria.</p>