Prevalence of blaKPC-2, blaKPC-3 and blaKPC-30—Carrying Plasmids in Klebsiella pneumoniae Isolated in a Brazilian Hospital

Abstract

<i>Klebsiella pneumoniae</i> carbapenemase (KPC) actively hydrolyzes carbapenems, antibiotics often used a last-line treatment for multidrug-resistant bacteria. KPC clinical relevance resides in its widespread dissemination. In this work, we report the genomic context of KPC coding genes <i>bla</i>_KPC-2, <i>bla</i>_KPC-3 and <i>bla</i>_KPC-30 in multidrug-resistant <i>Klebsiella</i><i>pneumoniae</i> isolates from Brazil. Plasmids harboring <i>bla</i>_KPC-3 and <i>bla</i>_KPC-30 were identified. Fifteen additional carbapenem-resistant <i>K. pneumoniae</i> isolates were selected from the same tertiary hospital, collected over a period of 8 years. Their genomes were sequenced in order to evaluate the prevalence and dissemination of <i>bla</i>_KPC-harboring plasmids. We found that <i>bla</i>_KPC genes were mostly carried by one of two isoforms of transposon Tn<i>4401</i> (Tn<i>4401</i>a or Tn<i>4401</i>b) that were predominantly located on plasmids highly similar to the previously described plasmid pKPC_FCF3SP (IncN). The identified pKPC_FCF3SP-like plasmids carried either <i>bla</i>_KPC-2 or <i>bla</i>_KPC-30. Two <i>K. pneumoniae</i> isolates harbored pKpQIL-like (IncFII) plasmids, only recently identified in Brazil; one of them harbored <i>bla</i>_KPC-3 in a Tn<i>4401</i>a transposon. Underlining the risk of horizontal spread of KPC coding genes, this study reports the prevalence of <i>bla</i>_KPC-2 and the recent spread of <i>bla</i>_KPC-3, and <i>bla</i>_KPC-30, in association with different isoforms of Tn<i>4401</i>, together with high synteny of plasmid backbones among isolates studied here and in comparison with previous reports.