First report of Klebsiella pneumoniae co-producing OXA-181, CTX-M-55, and MCR-8 isolated from the patient with bacteremia

Haoyu Ge; Jie Qiao; Hao Xu; Ruishan Liu; Ruyan Chen; Chenyu Li; Xinjun Hu; Jiawei Zhou; Xiaobing Guo; Beiwen Zheng

doi:10.3389/fmicb.2022.1020500

First report of Klebsiella pneumoniae co-producing OXA-181, CTX-M-55, and MCR-8 isolated from the patient with bacteremia

Front Microbiol. 2022 Oct 14:13:1020500. doi: 10.3389/fmicb.2022.1020500. eCollection 2022.

Authors

Haoyu Ge^{1

2}, Jie Qiao^{1

2}, Hao Xu¹, Ruishan Liu¹, Ruyan Chen², Chenyu Li², Xinjun Hu³, Jiawei Zhou¹, Xiaobing Guo², Beiwen Zheng^{1

4

5}

Affiliations

¹ Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
² Department of Laboratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
³ Department of Infectious Diseases, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang, China.
⁴ Department of Structure and Morphology, Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China.
⁵ Research Units of Infectious Diseases and Microecology, Chinese Academy of Medical Sciences, Beijing, China.

Abstract

The worldwide spread of carbapenem-resistant Enterobacteriaceae (CRE) has led to a major challenge to human health. In this case, colistin is often used to treat the infection caused by CRE. However, the coexistence of genes conferring resistance to carbapenem and colistin is of great concern. In this work, we reported the coexistence of bla _OXA-181, bla _CTX-M-55, and mcr-8 in an ST273 Klebsiella pneumoniae isolate for the first time. The species identification was performed using MALDI-TOF MS, and the presence of various antimicrobial resistance genes (ARGs) and virulence genes were detected by PCR and whole-genome sequencing. Antimicrobial susceptibility testing showed that K. pneumoniae 5589 was resistant to aztreonam, imipenem, meropenem, ceftriaxone, cefotaxime, ceftazidime, levofloxacin, ciprofloxacin, gentamicin, piperacillin-tazobactam, cefepime, and polymyxin B, but sensitive to amikacin. S1-pulsed-field gel electrophoresis (PFGE) and Southern blotting revealed the mcr-8 gene was carried on a ~ 138 kb plasmid with a conserved structure (IS903B-ymoA-inhA-mcr-8-copR-baeS-dgkA-ampC). In addition, bla _OXA-181 was found on another ~51 kb plasmid with a composite transposon flanked by insertion sequence IS26. The in vitro conjugation experiments and plasmid sequence probe indicated that the plasmid p5589-OXA-181 and the p5589-mcr-8 were conjugative, which may contribute to the propagation of ARGs. Relevant detection and investigation measures should be taken to control the prevalence of pathogens coharboring bla _OXA-181, bla _CTX-M-55 and mcr-8.

Keywords: CTX-M-55; Klebsiella pneumoniae; MCR-8; OXA-181; bacteremia.