Emergence of a Multidrug-Resistant Hypervirulent Klebsiella pneumoniae Sequence Type 23 Strain with a Rare blaCTX-M-24-Harboring Virulence Plasmid

Antimicrob Agents Chemother. 2019 Feb 26;63(3):e02273-18. doi: 10.1128/AAC.02273-18. Print 2019 Mar.

Abstract

Here, we report a multidrug-resistant hypervirulent Klebsiella pneumoniae (MDR-HvKP) strain of sequence type 23 (ST23) with a rare hybrid plasmid harboring virulence genes and blaCTX-M-24, and we analyze the genetic basis for relationship between genotypes and MDR-hypervirulence phenotypes. Further analysis indicates that the hybrid plasmid is formed by IS903D-mediated intermolecular transposition of the blaCTX-M-24 gene into the virulence plasmid. The emergence of MDR-HvKP strains, especially those carrying drug-resistant virulent plasmids, poses unprecedented threats/challenges to public health. This is a dangerous trend and should be closely monitored.

Keywords: Klebsiella pneumoniae; ST23; blaCTX-M-24; high-pathogenicity island; horizontal gene transfer (HGT); mobile genetic elements (MGEs); multidrug-resistant and hypervirulent Klebsiella pneumoniae (MDR-HvKP); virulent plasmid.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Proteins / genetics*
  • Drug Resistance, Multiple, Bacterial / genetics*
  • Genome, Bacterial / genetics
  • Humans
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / microbiology
  • Klebsiella pneumoniae / drug effects*
  • Klebsiella pneumoniae / genetics*
  • Klebsiella pneumoniae / isolation & purification
  • Klebsiella pneumoniae / pathogenicity
  • Male
  • Microbial Sensitivity Tests
  • Moths / microbiology
  • Plasmids / genetics*
  • Virulence / genetics
  • Virulence Factors / genetics
  • beta-Lactamases / genetics*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Virulence Factors
  • CTX-M-24 beta-lactamase protein, Klebsiella pneumoniae
  • beta-Lactamases