Dissemination and Stability of the <italic toggle="yes">bla</italic><sub>NDM-5</sub>-Carrying IncX3-Type Plasmid among Multiclonal <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Isolates

ABSTRACT NDM-5 carbapenemase was mainly identified in Escherichia coli, while the rapid transmission of blaNDM-5 among Enterobacteriaceae has raised serious public attention. This study identified 14 NDM-5-producing Klebsiella pneumoniae isolates from 107 carbapenem-resistant K. pneumoniae isolates,...

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Autores principales:	Wenjun Zhu, Xing Wang, Juanxiu Qin, Wei Liang, Zhen Shen
Formato:	article
Lenguaje:	EN
Publicado:	American Society for Microbiology 2020
Materias:	IncX3 plasmid K. pneumoniae NDM-5 conjugal transfer plasmid stability Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/c0892b163ab1434fa290df8268c13e55
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spelling	oai:doaj.org-article:c0892b163ab1434fa290df8268c13e552021-11-15T15:31:13ZDissemination and Stability of the <italic toggle="yes">bla</italic><sub>NDM-5</sub>-Carrying IncX3-Type Plasmid among Multiclonal <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Isolates10.1128/mSphere.00917-202379-5042https://doaj.org/article/c0892b163ab1434fa290df8268c13e552020-12-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mSphere.00917-20https://doaj.org/toc/2379-5042ABSTRACT NDM-5 carbapenemase was mainly identified in Escherichia coli, while the rapid transmission of blaNDM-5 among Enterobacteriaceae has raised serious public attention. This study identified 14 NDM-5-producing Klebsiella pneumoniae isolates from 107 carbapenem-resistant K. pneumoniae isolates, recovered from blood, urine, and normally sterile body fluids of pediatric patients from January 2016 to December 2018. All NDM-5-producing isolates were highly resistant to β-lactams, while tigecycline and polymyxin B exhibited excellent antimicrobial activity. These 14 strains belonged to 9 different sequence types (STs) and displayed various pulsed-field gel electrophoresis (PFGE) patterns, suggesting that they were not clonally related. S1-PFGE followed by Southern blotting showed that the blaNDM-5 gene was located on an ∼46-kb IncX3 plasmid in all strains. All blaNDM-5-carrying plasmids were successfully transferred into recipient E. coli J53. PCR-based sequencing demonstrated that all of the blaNDM-5-carrying plasmids shared highly similar backbones, with nucleotide sequence identity of >99%. Moreover, this plasmid displayed high sequence similarity to the previously reported epidemic IncX3 blaNDM-5-carrying plasmids, with dynamic changes observed only in blaNDM-5-surrounding elements. Interestingly, the IncX3 blaNDM-5-carrying plasmids showed strong stability in clinical isolates when cultured in antibiotic-free medium. However, after the conjugation inhibitor linoleic acid was added, a gradual increase in the level of IncX3 plasmid loss could be observed. Clinical isolates displayed 10% to 15% blaNDM-5-carrying plasmid loss after coculture with linoleic acid for 5 days. These results showed that the IncX3 plasmid facilitated the dissemination of blaNDM-5 among multiclonal K. pneumoniae strains in children and that conjugal transfer contributed significantly to IncX3 plasmid stability within K. pneumoniae. IMPORTANCE The emergence and spread of New Delhi metallo-β-lactamase (NDM)-producing Enterobacteriaceae have been a serious challenge to public health, and NDM-5 shows increased resistance to carbapenems compared with other variants. NDM-5 has been identified mostly in E. coli but has rarely been described in K. pneumoniae and other Enterobacteriaceae isolates. Here, we present the dissemination of highly similar 46-kb IncX3 blaNDM-5-carrying plasmids among multiclonal K. pneumoniae strains in children, highlighting the horizontal gene transfer of blaNDM-5 among K. pneumoniae strains via the IncX3 plasmid. Moreover, the IncX3 blaNDM-5-carrying plasmids displayed strong stability in clinical strains when cultured in antibiotic-free medium, and the plasmid maintenance was attributed partly to conjugal transfer. Plasmid conjugation is mediated by the type IV secretion system (T4SS), and T4SS is conserved among all epidemic IncX3 blaNDM-5-carrying plasmids. Therefore, combining conjugation inhibition and promotion of plasmid loss would be an effective strategy to limit the conjugation-assisted persistence of IncX3 blaNDM-5-carrying plasmids.Wenjun ZhuXing WangJuanxiu QinWei LiangZhen ShenAmerican Society for MicrobiologyarticleIncX3 plasmidK. pneumoniaeNDM-5conjugal transferplasmid stabilityMicrobiologyQR1-502ENmSphere, Vol 5, Iss 6 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	IncX3 plasmid K. pneumoniae NDM-5 conjugal transfer plasmid stability Microbiology QR1-502
spellingShingle	IncX3 plasmid K. pneumoniae NDM-5 conjugal transfer plasmid stability Microbiology QR1-502 Wenjun Zhu Xing Wang Juanxiu Qin Wei Liang Zhen Shen Dissemination and Stability of the <italic toggle="yes">bla</italic><sub>NDM-5</sub>-Carrying IncX3-Type Plasmid among Multiclonal <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Isolates
description	ABSTRACT NDM-5 carbapenemase was mainly identified in Escherichia coli, while the rapid transmission of blaNDM-5 among Enterobacteriaceae has raised serious public attention. This study identified 14 NDM-5-producing Klebsiella pneumoniae isolates from 107 carbapenem-resistant K. pneumoniae isolates, recovered from blood, urine, and normally sterile body fluids of pediatric patients from January 2016 to December 2018. All NDM-5-producing isolates were highly resistant to β-lactams, while tigecycline and polymyxin B exhibited excellent antimicrobial activity. These 14 strains belonged to 9 different sequence types (STs) and displayed various pulsed-field gel electrophoresis (PFGE) patterns, suggesting that they were not clonally related. S1-PFGE followed by Southern blotting showed that the blaNDM-5 gene was located on an ∼46-kb IncX3 plasmid in all strains. All blaNDM-5-carrying plasmids were successfully transferred into recipient E. coli J53. PCR-based sequencing demonstrated that all of the blaNDM-5-carrying plasmids shared highly similar backbones, with nucleotide sequence identity of >99%. Moreover, this plasmid displayed high sequence similarity to the previously reported epidemic IncX3 blaNDM-5-carrying plasmids, with dynamic changes observed only in blaNDM-5-surrounding elements. Interestingly, the IncX3 blaNDM-5-carrying plasmids showed strong stability in clinical isolates when cultured in antibiotic-free medium. However, after the conjugation inhibitor linoleic acid was added, a gradual increase in the level of IncX3 plasmid loss could be observed. Clinical isolates displayed 10% to 15% blaNDM-5-carrying plasmid loss after coculture with linoleic acid for 5 days. These results showed that the IncX3 plasmid facilitated the dissemination of blaNDM-5 among multiclonal K. pneumoniae strains in children and that conjugal transfer contributed significantly to IncX3 plasmid stability within K. pneumoniae. IMPORTANCE The emergence and spread of New Delhi metallo-β-lactamase (NDM)-producing Enterobacteriaceae have been a serious challenge to public health, and NDM-5 shows increased resistance to carbapenems compared with other variants. NDM-5 has been identified mostly in E. coli but has rarely been described in K. pneumoniae and other Enterobacteriaceae isolates. Here, we present the dissemination of highly similar 46-kb IncX3 blaNDM-5-carrying plasmids among multiclonal K. pneumoniae strains in children, highlighting the horizontal gene transfer of blaNDM-5 among K. pneumoniae strains via the IncX3 plasmid. Moreover, the IncX3 blaNDM-5-carrying plasmids displayed strong stability in clinical strains when cultured in antibiotic-free medium, and the plasmid maintenance was attributed partly to conjugal transfer. Plasmid conjugation is mediated by the type IV secretion system (T4SS), and T4SS is conserved among all epidemic IncX3 blaNDM-5-carrying plasmids. Therefore, combining conjugation inhibition and promotion of plasmid loss would be an effective strategy to limit the conjugation-assisted persistence of IncX3 blaNDM-5-carrying plasmids.
format	article
author	Wenjun Zhu Xing Wang Juanxiu Qin Wei Liang Zhen Shen
author_facet	Wenjun Zhu Xing Wang Juanxiu Qin Wei Liang Zhen Shen
author_sort	Wenjun Zhu
title	Dissemination and Stability of the <italic toggle="yes">bla</italic><sub>NDM-5</sub>-Carrying IncX3-Type Plasmid among Multiclonal <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Isolates
title_short	Dissemination and Stability of the <italic toggle="yes">bla</italic><sub>NDM-5</sub>-Carrying IncX3-Type Plasmid among Multiclonal <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Isolates
title_full	Dissemination and Stability of the <italic toggle="yes">bla</italic><sub>NDM-5</sub>-Carrying IncX3-Type Plasmid among Multiclonal <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Isolates
title_fullStr	Dissemination and Stability of the <italic toggle="yes">bla</italic><sub>NDM-5</sub>-Carrying IncX3-Type Plasmid among Multiclonal <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Isolates
title_full_unstemmed	Dissemination and Stability of the <italic toggle="yes">bla</italic><sub>NDM-5</sub>-Carrying IncX3-Type Plasmid among Multiclonal <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Isolates
title_sort	dissemination and stability of the <italic toggle="yes">bla</italic><sub>ndm-5</sub>-carrying incx3-type plasmid among multiclonal <named-content content-type="genus-species">klebsiella pneumoniae</named-content> isolates
publisher	American Society for Microbiology
publishDate	2020
url	https://doaj.org/article/c0892b163ab1434fa290df8268c13e55
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Dissemination and Stability of the <italic toggle="yes">bla</italic><sub>NDM-5</sub>-Carrying IncX3-Type Plasmid among Multiclonal <named-content content-type="genus-species">Klebsiella pneumoniae</named-content> Isolates

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