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. 2025 Jul;30(27):2500439.
doi: 10.2807/1560-7917.ES.2025.30.27.2500439.

Cross-border spread of a mosaic resistance (OXA-48) and virulence (aerobactin) plasmid in Klebsiella pneumoniae: a European Antimicrobial Resistance Genes Surveillance Network investigation, Europe, February 2019 to October 2024

Marius Linkevicius  1 , Erik Alm  1 , Louise Roer  2   3   4 , Olov Svartström  1 , Maria Dada-Olorunwa  1 , Kati Räisänen  5 , Felix Reichert  6 , Sophie Möller  7 , Christina Clarke  8 , Martin Cormican  9 , Baiba Niedre-Otomere  10 , Reinis Vangravs  10 , Paulius Greičius  11 , Olga Burduniuc  12 , Maria Anton  12 , Antoni P A Hendrickx  13   4 , Sandra Witteveen  13 , Vilhelm Müller  14 , Daniel Palm  1 , Diamantis Plachouras  1 , Dominique L Monnet  1 , Henrik Hasman  2   3   4 , Anke Kohlenberg  1
Affiliations

Cross-border spread of a mosaic resistance (OXA-48) and virulence (aerobactin) plasmid in Klebsiella pneumoniae: a European Antimicrobial Resistance Genes Surveillance Network investigation, Europe, February 2019 to October 2024

Marius Linkevicius et al. Euro Surveill. 2025 Jul.

Abstract

An investigation of the European Antimicrobial Resistance Genes Surveillance Network (EURGen-Net) detected the same mosaic IncHI1B(pNDM-MAR) resistance (OXA-48) and virulence (aerobactin) plasmid in 492 Klebsiella pneumoniae isolates from eight European Union countries during 2019-2024. Involvement of various K. pneumoniae sequence types (STs), multiple introductions, followed by large clonal outbreaks of three STs (ST147, ST392, ST45) carrying the plasmid in two countries indicate a high risk for further spread of this plasmid and a potential for difficult-to-treat K. pneumoniae infections to rise.

Keywords: Carbapenemase-producing Enterobacterales; antimicrobial resistance; cross-border spread; surveillance; virulence; whole genome sequencing.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

This figure shows a diagram of a mosaic resistance and virulence plasmid with the key markers blaOXA-48, aerobactin iucABCD and iutA genes, the IncHI1B(pNDM-MAR) replicon, as well as a backbone specific oligonucleotide marker.
Figure 1
Diagram of a mosaic resistance and virulence plasmid representative sequence with the key markers blaOXA-48, aerobactin genes (iucABCD, iutA) and IncHI1B(pNDM-MAR) replicon as well as a backbone specific oligonucleotide marker
This figure shows a phylogenetic tree based on genetic sequences of Klebsiella pneumoniae isolates carrying the mosaic resistance and virulence plasmid.
Figure 2
Phylogenetic tree of Klebsiella pneumoniae isolates carrying the mosaic resistance and virulence plasmid, February 2019–October 2024 (n = 604)
Figure 3
Figure 3
Time distributiona of Klebsiella pneumoniae isolates carrying the mosaic resistance and virulence plasmid by country, February 2019–October 2024 (n = 604)
See this image and copyright information in PMC

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