Prevalence of bla(KPC-2), bla(KPC-3) and bla(KPC-30)—Carrying Plasmids in Klebsiella pneumoniae Isolated in a Brazilian Hospital

Klebsiella pneumoniae carbapenemase (KPC) actively hydrolyzes carbapenems, antibiotics often used a last-line treatment for multidrug-resistant bacteria. KPC clinical relevance resides in its widespread dissemination. In this work, we report the genomic context of KPC coding genes bla(KPC-2), bla(KPC-3) and bla(KPC-30) in multidrug-resistant Klebsiella pneumoniae isolates from Brazil. Plasmids harboring bla(KPC-3) and bla(KPC-30) were identified. Fifteen additional carbapenem-resistant K. pneumoniae isolates were selected from the same tertiary hospital, collected over a period of 8 years. Their genomes were sequenced in order to evaluate the prevalence and dissemination of bla(KPC)–harboring plasmids. We found that bla(KPC) genes were mostly carried by one of two isoforms of transposon Tn4401 (Tn4401a or Tn4401b) that were predominantly located on plasmids highly similar to the previously described plasmid pKPC_FCF3SP (IncN). The identified pKPC_FCF3SP-like plasmids carried either bla(KPC-2) or bla(KPC-30). Two K. pneumoniae isolates harbored pKpQIL-like (IncFII) plasmids, only recently identified in Brazil; one of them harbored bla(KPC-3) in a Tn4401a transposon. Underlining the risk of horizontal spread of KPC coding genes, this study reports the prevalence of bla(KPC-2) and the recent spread of bla(KPC-3,) and bla(KPC-30), in association with different isoforms of Tn4401, together with high synteny of plasmid backbones among isolates studied here and in comparison with previous reports.