Genomic analysis of carbapenemase-encoding plasmids and antibiotic resistance in carbapenem-resistant Klebsiella pneumoniae isolates from Vietnam, 2021

作者：Göpel L, Linh LTK, Sy BT, Boutin S, Weikert-Asbeck S, Eger E, Hauswaldt S, My TN, Kocer K, The NT, Rupp J, Song LH, Schaufler K, Velavan TP, Nurjadi D · 发表于：Microbiology spectrum · 年份：2025 · DOI：10.1128/spectrum.03115-24 · 被引用次数：27 · 研究领域：Klebsiella pneumoniae、Plasmids、beta-Lactamases、Bacterial Proteins、Anti-Bacterial Agents、Klebsiella Infections、Carbapenem-Resistant Enterobacteriaceae、Vietnam、Humans、Microbial Sensitivity Tests、Carbapenems、Drug Resistance, Multiple, Bacterial

Carbapenem resistance in gram-negative rods is increasing in low- and middle-income countries. We conducted a single-center study to identify carbapenemase-encoding plasmids in carbapenem-resistant Klebsiella pneumoniae isolates causing human infections in Vietnam. The secondary objective was to investigate the prevalence of multidrug-resistant (MDR) and hypervirulent K. pneumoniae in this setting. Our genomic analysis study characterized 105 of 245 clinical K. pneumoniae isolates at the 108 Military Hospital in Hanoi, Vietnam, collected from intensive care unit and regular wards between 1 January 2021 and 31 December 2021. All isolates were characterized using long- and short-read sequencing, followed by hybrid assembly. Comprehensive genomic analysis was performed to identify carbapenemase-encoding plasmids, complemented by extended antibiotic susceptibility testing for commonly used and novel antibiotics. We observed a high prevalence of NDM-4-related carbapenem resistance (30.5%, 32/105) mostly carried by a specific 83-kb IncFII plasmid co-carrying the bla TEM-1 (46.9%, 15/32). The genomic content of the bla NDM-4-harboring plasmids is highly variable. While bla OXA-181 and bla OXA-48 were predominantly located on an IncX3 and an IncL plasmid, respectively, the majority of plasmids harboring bla KPC-2 were not related to any named Inc-type. All isolates exhibited the MDR phenotype; however, the majority remained susceptible to the siderophore-cephalosporin cefiderocol (79...