Co-Existence of KPC-2, LAP-2, and CTX-M-65 in an ST1469 Multidrug-Resistant Klebsiella pneumoniae Strain in China

PURPOSE: Beta-lactamase-producing Klebsiella pneumoniae is common in the clinic, but research associated with the co-existence of KPC-2, LAP-2, and CTX-M-65 in K. pneumoniae is still rare. In this study, the phenotypic and genetic characteristics of a multidrug-resistant K. pneumoniae strain SJ25 co-harboring bla(KPC-2), bla(LAP-2), and bla(CTX-M-65) with rare ST1469 were investigated. METHODS AND RESULTS: Antimicrobial susceptibility testing revealed that strain SJ25 was resistant to various common antibiotics, except ciprofloxacin, fosfomycin, colistin, and tigecycline. Whole-genome analysis revealed that strain SJ25 carries a variety of antimicrobial resistance genes and virulence determinants. Plasmid analysis confirmed that the bla(KPC-2) and bla(CTX-M-65) genes were located on an ~136 kb transferrable IncFII/IncR plasmid and that bla(LAP-2) was located on an untypeable plasmid. CONCLUSION: Our findings emphasized the need for continuous surveillance of β-lactamase-bearing K. pneumoniae in the clinic to control potential dissemination and outbreak.