Rapidly disseminating blaOXA-232 carrying Klebsiella pneumoniae belonging to ST231 in India: multiple and varied mobile genetic elements

Chaitra Shankar; Purva Mathur; Manigandan Venkatesan; Agila Kumari Pragasam; Shalini Anandan; Surbhi Khurana; Balaji Veeraraghavan

doi:10.1186/s12866-019-1513-8

Rapidly disseminating bla_OXA-232 carrying Klebsiella pneumoniae belonging to ST231 in India: multiple and varied mobile genetic elements

BMC Microbiol. 2019 Jun 24;19(1):137. doi: 10.1186/s12866-019-1513-8.

Authors

Chaitra Shankar¹, Purva Mathur², Manigandan Venkatesan¹, Agila Kumari Pragasam¹, Shalini Anandan¹, Surbhi Khurana³, Balaji Veeraraghavan¹

Affiliations

¹ Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
² Department of Laboratory Medicine JRNA Trauma Centre, All India Institute of Medical Sciences, New Delhi, India. purvamathur@yahoo.co.in.
³ Department of Laboratory Medicine JRNA Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.

Abstract

Background: Recently, in India, there has been a shift from NDM to OXA48-like carbapenemases. OXA-181 and OXA-232 are the frequently produced variants of OXA48-like carbapenemases. OXA48-like carbapenemases are also known to be carried on transposons such as Tn1999, Tn1999.2 and it is also associated with IS1R carried on Tn1999. In India, there are no previous reports studying the association of mobile genetic elements (MGEs) with OXA48-like carbapenemases. The present study was aimed at determining the genetic backbone of OXA48-like carbapenemases to determine the role of MGEs in its transfer and to investigate the Inc plasmid type carrying bla_OXA48-like.

Results: A total of 49 carbapenem resistant K. pneumoniae which included 25 isolates from South India and 24 isolates from North India, were included in the study. Whole genome sequencing using Ion Torrent PGM was performed to study the isolates. OXA-232 was present in 35 isolates (71%). In 19 isolates (39%), bla_OXA48-like was associated with MGEs. Insertion sequences such as ISX4, IS1, IS3, ISKpn1, ISKpn26, ISKpn25, ISSpu2, ISKox1, IS4321R, ISEc36, and ISPa38; and transposons such as TnAs3 and Tn2, were present. Isolates from northern and southern India belonging to same sequence type (ST) had diverse genetic backbone for bla_OXA48-like. ST14 isolates from north had IS5 and Tn3 families while from south they had IS1, IS5 and IS630 families. ST231 from north had IS5, IS6 and Tn3 families with bla_OXA-232 while from south, IS1, IS3 and IS5 families were observed; with ISKpn26 being present among isolates from both the regions. bla_OXA48-like was predominantly found on ColKP3 plasmid. ST231 was the predominant ST in 22 isolates (45%).

Conclusion: OXA-232 is the predominant variant of OXA48-like carbapenemase with ST231 being the commonest ST of OXA48-like carbapenemase producing K. pneumoniae in India. Diverse MGEs have been associated with both bla_OXA-232 and bla_OXA-181 which contribute to their spread. The MGEs in the present study are different from those reported earlier. There is no clonal expansion of bla_OXA48-like producing K. pneumoniae since diverse STs were observed. Monitoring the genetic backbone of OXA48-like carbapenemase is essential to better understand the transmission dynamics of XDR K. pneumoniae.

Keywords: India; Insertion sequences; K. pneumoniae; ST231; Transposons; bla OXA-232.

MeSH terms

Bacterial Proteins / genetics*
DNA Transposable Elements*
DNA, Bacterial / genetics
Genetic Variation
Humans
India
Klebsiella Infections / microbiology*
Klebsiella pneumoniae / genetics*
Klebsiella pneumoniae / isolation & purification
Plasmids / genetics
Whole Genome Sequencing
beta-Lactamases / genetics*

Substances

Bacterial Proteins
DNA Transposable Elements
DNA, Bacterial
beta-Lactamases
carbapenemase