Liu Xu, Zhang Tingting, Yu Zhiyang, Qin Shangshang, Zhang Muchen, Li Yan
Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
XNA Platform, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, Henan, China.
Front Microbiol. 2025 May 27;16:1601035. doi: 10.3389/fmicb.2025.1601035. eCollection 2025.
The emergence of polymyxin-resistant carbapenem-resistant (CRKP) severely limits clinical treatment options and poses a significant threat to anti-infective therapy. In this study, we investigated the genetic characteristics of an IncHI5-like plasmid co-harboring and in an -positive clinical CRKP isolate using a combination of MIC testing, conjugation experiments, bacterial whole-genome sequencing, and bioinformatics analyses. The ST626 CRKP strain KP19-2581, isolated from a human clinical infection, exhibited a multidrug-resistant (MDR) phenotype. Whole-genome sequencing revealed that the colistin resistance gene was located on an IncFIA/IncFII plasmid, flanked by the conserved structure IS---IS. In addition, strain KP19-2581 carried a novel IncHI5-like MDR plasmid, designated pKP19-2581-367k-HI5-NDM1, which co-harbored the and genes. This plasmid contained two MDR regions, harboring a diverse array of resistance genes across multiple antibiotic classes. The dissemination of in variable region is related to the structure of class 1 integron, while IS mediates the integration of on IncHI5-like plasmid. Notably, this is the first report of an IncHI5-like plasmid carrying both and two copies of , along with multiple resistance genes and insertion sequences. Given its potential to acquire additional resistance determinants, this plasmid may serve as a reservoir for further antimicrobial resistance evolution, underscoring the urgent need for surveillance of IncHI5 plasmids to mitigate their clinical and epidemiological impact.
耐多粘菌素碳青霉烯耐药性（CRKP）的出现严重限制了临床治疗选择，并对抗感染治疗构成了重大威胁。在本研究中，我们结合最小抑菌浓度（MIC）测试、接合实验、细菌全基因组测序和生物信息学分析，研究了一株携带blaNDM-1和blaOXA-48的临床CRKP阳性分离株中一种IncHI5样质粒的遗传特征。从人类临床感染中分离出的ST626 CRKP菌株KP19-2581表现出多重耐药（MDR）表型。全基因组测序显示，粘菌素耐药基因mcr-1位于IncFIA/IncFII质粒上，两侧为保守结构IS26---IS26。此外，菌株KP19-2581携带一种新型IncHI5样MDR质粒，命名为pKP19-2581-367k-HI5-NDM1，它同时携带blaNDM-1和blaOXA-48基因。该质粒包含两个MDR区域，含有多种抗生素类别的多种耐药基因。blaOXA-48在可变区的传播与1类整合子的结构有关，而IS26介导blaNDM-1在IncHI5样质粒上的整合。值得注意的是，这是首次报道携带blaNDM-1和两个blaOXA-48拷贝以及多个耐药基因和插入序列的IncHI5样质粒。鉴于其获得额外耐药决定因素的潜力，该质粒可能成为进一步抗菌药物耐药性进化的储存库，凸显了监测IncHI5质粒以减轻其临床和流行病学影响的迫切需求。
