Outbreak of <i>bla</i> _NDM-5 -Harboring <i>Klebsiella pneumoniae</i> ST290 in a Tertiary Hospital in China

Abstract

The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) has posed a great threat to public health. Among 133 nonduplicated CRKP isolates collected between September 2016 and November 2017 in a tertiary hospital in China, 89 (89/133, 66.9%) and 31 (31/133, 23.3%) were positive for bla NDM-5 and bla KPC-2 . Multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) revealed that ST290 represented the majority of NDM-5 producers (67/89, 75.3%) and PFGE cluster E accounted for 50 (50/67, 74.6%) ST290 isolates from the burn ward, suggesting that K. pneumoniae ST290 clone carrying bla NDM-5 resulted in an outbreak in this hospital. Whole genome sequencing of the plasmid carrying bla NDM-5 showed that the resistance gene bla NDM-5 was located in a ∼49 kb multireplicon plasmid with a peculiar insertion of IS Kpn19 of the IncX3-type plasmid. To the best of our knowledge, this is the first report of outbreak of K. pneumoniae ST290 clone carrying bla NDM-5 .