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Genetic diversity and co-prevalence of ESBLs and PMQR genes among plasmid-mediated AmpC β-lactamase-producing Klebsiella pneumoniae isolates causing urinary tract infection

The Journal of Antibiotics volume 74, pages 397–406 (2021)Cite this article

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Abstract

Klebsiella pneumoniae is an opportunistic pathogen that frequently causes nosocomial urinary tract infection (UTI). The aim of this study was to investigate the prevalence of extended-spectrum β-lactamases (ESBL), plasmid-mediated quinolone resistance (PMQR) genes, in acquired AmpC (ac-AmpC) β‑lactamase‑producing K. pneumoniae isolates from patients with nosocomial UTI and to characterize the transmissibility of plasmids harbouring multiple resistance genes. From January 2017 to June 2018, we collected 46 ac-AmpC-producing K. pneumoniae isolates causing UTI from a tertiary care hospital in China. Antimicrobial susceptibility assays showed that non-susceptibility of all isolates to third-generation cephalosporin and fluoroquinolone was very high (>80%). Diverse types of ESBLs and PMQR genes, including blaSHV-12 (n = 23), blaSHV-27 (n = 1), blaSHV-28 (n = 2), blaSHV-33 (n = 4), blaCTX-M-3 (n = 24), blaCTX-M-14 (n = 6), blaCTX-M-15 (n = 6), blaCTX-M-22 (n = 1) and blaOXA-10 (n = 26), as well as qnrA (n = 2), qnrB (n = 39) and qnrS (n = 2) genes were identified amongst AmpC-producing K. pneumoniae isolates. The blaAmpC, qnrB and several ESBLs genes from six strains harbouring multiple AmpC (at least two ampC) were co-transferrable to recipients via conjugation or electroporation, with IncFIA, IncFIB and IncA/C being the dominant replicons. Conserved genetic context associated with the mobilization of blaampC genes was detected. Forty-six isolates were categorized into 25 enterobacterial repetitive intergenic consensus (ERIC) types, and the 6 isolates harbouring multiple AmpC genes belonged to ST1 lineage. This work reports that the emergence of plasmids co-harbouring multiple resistance determinants and mediating the local prevalence in K. pneumoniae causing UTI in China.

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Acknowledgements

We thank Dr. Hui Xu for providing PCR controls.

Funding

This work was supported by the National Natural Science Foundation of China (grant number 81401697), the Natural Science Foundation of Liaoning Province (grant number 2019-MS-092), Scientific Research Project of the Education Department of Liaoning Province (grant number LZ2020052) and the Program for High-Level Entrepreneurial and Innovative Talents of Dalian, China (2017RQ120). This work was also supported by the Liaoning Provincial Program for Top Discipline of Basic Medical Sciences.

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  1. These authors contributed equally: Yilin Xiong, Cong Zhang, Wenting Gao

Authors and Affiliations

  1. Department of Biotechnology, Basic Medical College, Dalian Medical University, Dalian, China

    Yilin Xiong, Yuqiao Han, Shiyu Jiang, Zinan Zhao, Jia Wang & Yang Chen

  2. Department of Nutrition and Food Hygiene, School of Public Health, Dalian Medical University, Dalian, China

    Cong Zhang

  3. Institute of Genome Engineered Animal Models for Human Disease, Dalian Medical University, Dalian, China

    Wenting Gao & Yong Ma

  4. Department of Pathology, Basic Medical College, Dalian Medical University, Dalian, China

    Qingqing Zhang

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Xiong, Y., Zhang, C., Gao, W. et al. Genetic diversity and co-prevalence of ESBLs and PMQR genes among plasmid-mediated AmpC β-lactamase-producing Klebsiella pneumoniae isolates causing urinary tract infection. J Antibiot 74, 397–406 (2021). https://doi.org/10.1038/s41429-021-00413-6

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