Plasmidome analyses of Klebsiella pneumoniae co-producing blaKPC-2 and blaNDM-1 in Southern Brazil: characterisation of mobile genetic elements
2025
Mayana Kieling Hernandez Berdichevski | Rafaela R. Guerra | Dariane C. Pereira | Camila M. Wilhelm | Patricia O. Barth | Melise C. Silveira | Fabiana C.Z. Volpato | Claudio Rocha-de-Souza | Richard M. Carrassai | Ana Paula Carvalho-Assef | Andreza F. Martins | Afonso Luís Barth
ABSTRACT: Objective: Infections due to carbapenemase-producing Enterobacterales harbouring more than one carbapenemase-encoding gene spread mainly by plasmid and transposon mobilisation. The objective of this study was to analyse the mobile genetic elements carrying blaKPC and blaNDM of Klebsiella pneumoniae carbapenemase co-producers (KpKN). Methods: K. pneumoniae isolates with reduced susceptibility to carbapenems were obtained between 2016 and 2023. To evaluate the genetic environment of KpKN, 22 isolates were selected for antimicrobial susceptibility testing and whole-genome sequencing. Results: The blaKPC-2 gene was carried mainly by IncN/IncFIB, a novel co-integrated plasmid in the Tn4401b transposon. blaNDM-1 was disseminated in the only two KpKN isolates recovered prior to 2020 by the IncHI1B/IncFIB plasmid type within the Tn3000 transposon. Significantly, isolates obtained since 2020 showed the blaNDM-1 gene carried by IncA/C in an IS26-flanked pseudo-composite transposon containing ISCR1, which also had genes that conferred resistance to sulfonamides, aminoglycosides, macrolides, quinolones, amphenicols, tetracyclines, rifampicin, sulfonamide, and trimethoprim. The isolates belonged mainly to ST11 and ST16. Conclusions: Plasmid and transposon changes during different periods could be related to higher dissemination of blaNDM-1, and the large number of resistance genes present in the IS26-flanked transposon may have increased co-selection of this plasmid through the wide use of antimicrobials during the pandemic.
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