Prevalence of the NTEKPC-I on IncF Plasmids Among Hypervirulent Klebsiella pneumoniae Isolates in Jiangxi Province, South China

Qi-Sen Huang; Wenjian Liao; Zhijuan Xiong; Dan Li; Fang-Ling Du; Tian-Xin Xiang; DanDan Wei; La-Gen Wan; Yang Liu; Wei Zhang

doi:10.3389/fmicb.2021.622280

Prevalence of the NTE_KPC-I on IncF Plasmids Among Hypervirulent Klebsiella pneumoniae Isolates in Jiangxi Province, South China

Front Microbiol. 2021 Jun 21:12:622280. doi: 10.3389/fmicb.2021.622280. eCollection 2021.

Authors

Affiliations

¹ Department of Clinical Microbiology, First Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China.
² Department of Respiratory and Critical Care, First Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China.
³ Department of Infectious Disease, First Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China.

Abstract

Infection caused by carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) has become a tricky health care threat in China and KPC-2 enzyme is a main factor mediating resistance to carbapenems of K. pneumoniae. Here, we report the characterization of the genetic environment of the blaKPC-2 gene in CR-hvKP clinical isolates from South China. Forty-five non-duplicated CR-hvKP isolates collected in Jiangxi Province from 2018 to 2019 were analyzed. Each of them were multidrug-resistant due to the presence not only of blaKPC-2 gene but also of other resistance determinants, including Metallo-β-lactamases (NDM-1), extended-spectrum β-lactamases (TEM-1, CTX-M-14, SHV-1), and plasmid-mediated quinolone resistance determinants (qnrS, aac(6')-Ib-cr). After plasmid analyses of PCR-based replicon typing (PBRT), mapping PCR, amplicon sequencing, and whole-genome sequencing (WGS) were used to analyze the genetic environment of the blaKPC-2 gene. PCR analysis of pLVPK-like plasmids, Southern Blot, and mouse lethality assay were used to characterize the virulence phenotype of K. pneumoniae. Multilocus sequence typing (MLST) analysis showed ST11 CR-hvKP was the predominant clone. In conclusion, this is the first analysis of diverse genetic structures blaKPC-2 gene in CR-hvKP isolates from south China. Both the NTEKPC-I on the IncF plasmids and pLVPK-like virulence plasmids make contributions to the formation of CR-hvKP especially ST11 which need more attention.

Keywords: IncFII-like plasmids; NTEKPC-2; ST11; carbapenem resistance; hypervirulent Klebsiella pneumoniae.