Within-patient horizontal transfer of pOXA-48 from a hypervirulent Klebsiella pneumoniae SL218 to Serratia marcescens following spread of the K. pneumoniae isolate among hospitalised patients, Denmark, 2021

Euro Surveill. 2023 Apr;28(17):2300196. doi: 10.2807/1560-7917.ES.2023.28.17.2300196.

Abstract

A hypervirulent Klebsiella pneumoniae SL218 (ST23-KL57), phylogenetically distinct from the classical hypervirulent SL23 (ST23-KL1) lineage, was transmitted between hospitalised patients in Denmark in 2021. The isolate carried a hybrid resistance and virulence plasmid containing bla NDM-1 and a plasmid containing bla OXA-48 (pOXA-48); the latter plasmid was horizontally transferred within-patient to Serratia marcescens. The convergence of drug resistance and virulence factors in single plasmids and in different lineages of K. pneumoniae is concerning and requires surveillance.

Keywords: Hospital-acquired infections; OXA-48; antimicrobial resistance; hypervirulent K. pneumoniae; within-patient plasmid transfer.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Proteins / genetics
  • Denmark / epidemiology
  • Humans
  • Klebsiella Infections* / drug therapy
  • Klebsiella Infections* / epidemiology
  • Klebsiella pneumoniae* / genetics
  • Plasmids / genetics
  • Serratia marcescens / genetics
  • beta-Lactamases / genetics

Substances

  • beta-Lactamases
  • Bacterial Proteins
  • Anti-Bacterial Agents