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. 2021 Oct 13;21(1):1061.
doi: 10.1186/s12879-021-06758-5.

A transferrable IncL/M plasmid harboring a gene encoding IMP-1 metallo-β-lactamase in clinical isolates of Enterobacteriaceae

Nobuyoshi Mori  1   2 , Tatsuya Tada  3 , Satoshi Oshiro  2 , Kyoko Kuwahara-Arai  2 , Teruo Kirikae  2 , Yuki Uehara  2   4
Affiliations

A transferrable IncL/M plasmid harboring a gene encoding IMP-1 metallo-β-lactamase in clinical isolates of Enterobacteriaceae

Nobuyoshi Mori et al. BMC Infect Dis. .

Abstract

Background: The worldwide spread of carbapenemase-producing Enterobacteriaceae (CPE) has reduced the clinical utility of carbapenems. Plasmids often play an important role in the spread of genes encoding drug-resistance factors, especially in the horizontal transfer of these genes among species of Enterobacteriaceae. This study describes a patient infected with three species of CPE carrying an identical transferrable IncL/M plasmid.

Methods: Clinical isolates of CPE were collected at St. Luke's International Hospital, Tokyo, Japan, from 2015 to 2019. Three species of CPE isolates, Enterobacter cloacae, Klebsiella aerogenes and Serratia marcescens, were isolated from a patient who developed severe gallstone pancreatitis associated with bloodstream infection, with all three isolates producing IMP-1 metallo-β-lactamase. The complete sequences of the plasmids of the three isolates were determined by both MiSeq and MinION. The medical chart of this patient was retrospectively reviewed conducted to obtain relevant clinical information.

Results: The three CPE species carried an IncL/M plasmid, pSL264, which was 81,133 bp in size and harbored blaIMP-1. The genetic environment surrounding blaIMP-1 consisted of int1-blaIMP-1-aac(6')-IIc-qacL-qacEdelta1-sul1-istB-IS21. Conjugation experiments showed that S. marcescens could transmit the plasmid to E. cloacae and K. aerogenes. In contrast, pSL264 could not transfer from E. cloacae or K. aerogenes to S. marcescens.

Conclusion: The IncL/M plasmid pSL264 harboring blaIMP-1 was able to transfer among different species of Enterobacteriaceae in a patient receiving long-term antimicrobial treatment. The worldwide emergence and spread of IncL/M plasmids harboring carbapenemase-encoding genes among species of Enterobacteriaceae is becoming a serious public health hazard.

Keywords: Carbapenemase producing Enterobacteriaceae; IMP-1 metallo-β-lactamase; IncL/M.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Structure of the plasmid, pSL264, harboring blaIMP-1
Fig. 2
Fig. 2
Comparative analysis of plasmids highly similar to pSL264. pSL264 was 98.51% identical to the plasmid pEB-1 in E. cloacae (KX230795), 98.51% identical to pACM1 in Klebsiella oxytoca (KJ541681), 98.51% identical to p51929_MCR_VIM in Citrobacter freundii CP059429), and 98.52% identical to pKp616_2 in K. pneumoniae (CP026497)
Fig. 3
Fig. 3
Comparative analysis of the genomes of pSL264 and pTMTA63632. The sequence qacEdelta1-sul1-istB-IS21 of pSL264 was 99.25% identical to that of the plasmid TMTA63632 harboring blaIMP-68 (Accession Number AP019667) in a K. pneumoniae isolate obtained from a patient in Japan.c
Fig. 4
Fig. 4
The scheme of transferability of pSL264 among E. cloacae, K. aerogenes and S. marcescens
See this image and copyright information in PMC

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