Evolution of carbapenem resistance in klebsiella pneumoniae and escherichia coli carrying bla(NDM−1) gene: imipenem exposure results in sustained resistance memory of strains in vitro

BACKGROUND: Antibiotics exert an outstanding selective pressure on bacteria, forcing their chromosomal gene mutations and drug resistance genes to spread. The objective of this study is to evaluate the expression of the New Delhi Metallo-β-Lactamase-1 gene (bla(NDM−1)) in the clinical isolate (Klebsiella pneumoniae TH-P12158), transformant strains Escherichia coli BL21 (DE3)-bla(NDM−1), and Escherichia coli DH5α- bla(NDM−1) when exposed to imipenem. METHODS: β-Lactamase genes (bla(SHV), bla(TEM−1), bla(CTX−M−9), bla(IMP), bla(NDM−1), bla(KPC), bla(OXA), bla(GES), and bla(DHA)) from randomly selected carbapenems-sensitive K.pneumoniae (n = 20) and E.coli (n = 20) strains were amplified by PCR. The recombinant plasmid of pET-28a harboring bla(NDM−1) was transformed into E.coli BL21 (DE3) and E.coli DH5α by electroporation. The resistance phenotype and higher bla(NDM−1) expression in K.pneumoniae TH-P12158, transformant E.coli BL21 (DE3)-bla(NDM−1), and E.coli DH5α-bla(NDM−1) were observed when exposed to imipenem with grade increasing, decreasing, and canceling doses, respectively. RESULTS: After being exposed to different doses of imipenem, the minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of antimicrobial drugs and bla(NDM−1) expression of strains increased, which was positively correlated with doses of imipenem. On the contrary, with the decrease or cancellation of imipenem doses, the bla(NDM−1) expression was deteriorated, while the MIC and MBC values remained relatively stable. These results demonstrated that low doses of imipenem (˂MIC) could press bla(NDM−1) positive strains producing stable drug resistance memory and altered bla(NDM−1) expression. CONCLUSIONS: Low doses of imipenem could press bla(NDM−1) positive strains producing sustained resistance memory and altered bla(NDM−1) expression. In particular, the positive correlation between the resistance genes expression and antibiotics exposure shows promising guiding significance for clinical medication. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12941-023-00598-8.