Emergence of carbapenem-resistant Klebsiella pneumoniae harbouring bla OXA-48-like genes in China

Ying Chen, Li Fang, Yunxing Yang, Rushuang Yan, Ying Fu, Ping Shen, Dongdong Zhao, Yan Chen, Xiaoting Hua, Yan Jiang, Robert A Moran, Willem van Schaik, Yunsong Yu

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Klebsiella pneumoniae strains carrying OXA-48-like carbapenemases are increasingly prevalent across the globe. There is thus an urgent need to better understand the mechanisms that underpin the dissemination of bla OXA-48-like carbapenemases. To this end, four ertapenem-resistant K. pneumoniae isolates producing OXA-48-like carbapenemases were isolated from two patients. Genome sequencing revealed that one sequence type (ST) 17 isolate carried bla OXA-181, whilst three isolates from a single patient, two ST76 and one ST15, carried bla OXA-232. The 50514 bp bla OXA-181-harbouring plasmid, pOXA-181_YML0508, was X3-type with a conjugation frequency to Escherichia coli of 1.94×10-4 transconjugants per donor. The bla OXA-232 gene was located on a 6141 bp ColKP3-type plasmid, pOXA-232_WSD, that was identical in the ST76 and ST15 K. pneumoniae isolates. This plasmid could be transferred from K. pneumoniae to E. coli at low frequency, 8.13×10-6 transconjugants per donor. Comparative analysis revealed that the X3 plasmid acquired the bla OXA-48-like gene via IS3000-mediated co-integration of the ColKP3-type plasmid. Our study highlights how plasmid integration and rearrangements can contribute to the spread of bla OXA-48-like genes, which provides important clues for clinical prevention of the dissemination of K. pneumoniae strains carrying bla OXA-48-like carbapenemases.

Original languageEnglish
Article number001306
JournalJournal of Medical Microbiology
Issue number3
Early online date28 Jan 2021
Publication statusPublished - Mar 2021


  • Aged, 80 and over
  • Bacterial Proteins/genetics
  • Carbapenem-Resistant Enterobacteriaceae/genetics
  • China
  • Genes, Bacterial
  • Humans
  • Klebsiella Infections/microbiology
  • Klebsiella pneumoniae/drug effects
  • Male
  • Middle Aged
  • Plasmids
  • beta-Lactamases/genetics


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