Genomic epidemiology of global Klebsiella pneumoniae carbapenemase (KPC)-producing Escherichia coli
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Authors
Stoesser, N.
Sheppard, A.E.
Peirano, Gisele
Anson, L.W.
Pankhurst, L.
Sebra, R.
Phan, H.T.T.
Kasarskis, A.
Mathers, A.J.
Peto, T.E.A.
Journal Title
Journal ISSN
Volume Title
Publisher
Nature Publishing Group
Abstract
The dissemination of carbapenem resistance in Escherichia coli has major implications for the
management of common infections. blaKPC, encoding a transmissible carbapenemase (KPC), has
historically largely been associated with Klebsiella pneumoniae, a predominant plasmid (pKpQIL), and
a specific transposable element (Tn4401, ~10 kb). Here we characterize the genetic features of blaKPC
emergence in global E. coli, 2008–2013, using both long- and short-read whole-genome sequencing.
Amongst 43/45 successfully sequenced blaKPC-E. coli strains, we identified substantial strain diversity
(n = 21 sequence types, 18% of annotated genes in the core genome); substantial plasmid diversity (≥9
replicon types); and substantial blaKPC-associated, mobile genetic element (MGE) diversity (50% not
within complete Tn4401 elements). We also found evidence of inter-species, regional and international
plasmid spread. In several cases blaKPC was found on high copy number, small Col-like plasmids,
previously associated with horizontal transmission of resistance genes in the absence of antimicrobial
selection pressures. E. coli is a common human pathogen, but also a commensal in multiple
environmental and animal reservoirs, and easily transmissible. The association of blaKPC with a range of
MGEs previously linked to the successful spread of widely endemic resistance mechanisms (e.g. blaTEM,
blaCTX-M) suggests that it may become similarly prevalent.
Description
Keywords
Escherichia coli, Infections, Carbapenemase (KPC), Mobile genetic element (MGE), Resistance, Enterobacteriaceae, Emergence, Plasmids, Clinical isolate, Sequence type
Sustainable Development Goals
Citation
Stoesser, N., Sheppard, A.E., Peirano, G., Anson, L.W., Pankhurst, L., Sebra, R., Phan, H.T.T., Kasarskis, A., Mathers, A.J., Peto, T.E.A., Bradford, P., Motyl, M.R., Walker, A.S., Crook, D.W. & Pitout, J.D. 2017, 'Genomic epidemiology of global Klebsiella pneumoniae carbapenemase (KPC)-producing Escherichia coli', Scientific Reports, vol. 7, art. no. 5917, pp. 1-11.