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Extensively Drug-Resistant Escherichia coli Sequence Type 1642 Carrying an IncX3 Plasmid Containing the blaKPC-2 Gene Associated with Transposon Tn4401a

 Seri Jeong  ;  Jung Ok Kim  ;  Eun Jeong Yoon  ;  Il Kwon Bae  ;  Woonhyoung Lee  ;  Hyukmin Lee  ;  Yongjung Park  ;  Kyungwon Lee  ;  Seok Hoon Jeong 
 Annals of Laboratory Medicine, Vol.38(1) : 17-22, 2018 
Journal Title
 Annals of Laboratory Medicine 
Issue Date
Anti-Bacterial Agents/pharmacology ; DNA Transposable Elements/*genetics ; Bacterial/*genetics Drug Resistance ; Escherichia coli/drug effects/*genetics/isolation & purification ; Escherichia coli Proteins/genetics ; Genotype ; Humans ; Microbial Sensitivity Tests ; Multilocus Sequence Typing ; Plasmids/*genetics/metabolism ; Polymerase Chain Reaction ; Whole Genome Sequencing ; beta-Lactamases/genetics
Escherichia coli ; IncX3 ; ST1642 ; Tn4401a ; bla(KPC)
BACKGROUND: Extensively drug-resistant (XDR) Enterobacteriaceae carrying the bla(KPC) gene have emerged as a major global therapeutic concern. The purpose of this study was to analyze the complete sequences of plasmids from KPC-2 carbapenemase-producing XDR Escherichia coli sequence type (ST) 1642 isolates. METHODS: We performed antimicrobial susceptibility testing, PCR, multilocus sequence typing (MLST), and whole-genome sequencing to characterize the plasmid-mediated KPC-2-producing E. coli clinical isolates. RESULTS: The isolates were resistant to most available antibiotics, including meropenem, ampicillin, ceftriaxone, gentamicin, and ciprofloxacin, but susceptible to tigecycline and colistin. The isolates were identified as the rare ST1642 by MLST. The isolates carried four plasmids: the first 69-kb conjugative IncX3 plasmid harbors bla(KPC-2) within a truncated Tn4401a transposon and bla(SHV-11) with duplicated conjugative elements. The second 142-kb plasmid with a multireplicon consisting of IncQ, IncFIA, and IncIB carries bla(TEM-1b) and two class 1 integrons. This plasmid also harbors a wide variety of additional antimicrobial resistance genes including aadA5, dfrA17, mph(A), sul1, tet(B), aac(3')-IId, strA, strB, and sul2. CONCLUSIONS: The complete sequence analysis of plasmids from an XDR E. coli strain related to persistent infection showed the coexistence of a bla(KPC-2)-carrying IncX3-type plasmid and a class 1 integron-harboring multireplicon, suggesting its potential to cause outbreaks. Of additional clinical significance, the rare ST1642, identified in a cat, could constitute the source of human infection.
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1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
이경원(Lee, Kyungwon) ORCID logo https://orcid.org/0000-0003-3788-2134
이혁민(Lee, Hyuk Min) ORCID logo https://orcid.org/0000-0002-8523-4126
정석훈(Jeong, Seok Hoon) ORCID logo https://orcid.org/0000-0001-9290-897X
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