Decadal Evolution of KPC-related plasmids in Pseudomonas aeruginosa high-risk clone ST463 in Zhejiang, China

Yue Li; Qing Yang; Minhua Chen; Heng Cai; Li Fang; Junxin Zhou; Rui Weng; Hanming Ni; Yan Jiang; Xiaoting Hua; Yunsong Yu

doi:10.1038/s42003-024-07337-5

Decadal Evolution of KPC-related plasmids in Pseudomonas aeruginosa high-risk clone ST463 in Zhejiang, China

Commun Biol. 2024 Dec 19;7(1):1646. doi: 10.1038/s42003-024-07337-5.

Authors

Yue Li^#^{1

2

3}, Qing Yang^#^{4

5}, Minhua Chen^{1

6}, Heng Cai^{1

2

3}, Li Fang^{1

2

3}, Junxin Zhou^{1

2

3}, Rui Weng^{1

2

3}, Hanming Ni^{1

2

3}, Yan Jiang^{1

2

3}, Xiaoting Hua^{7

8

9}, Yunsong Yu^{10

11

12}

Affiliations

¹ Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
² Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
³ Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China.
⁴ Department of Laboratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
⁵ State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
⁶ Emergency and Critical Care Center, Intensive Care Unit, Zhejiang Provincial People's Hospital, Hangzhou, China.
⁷ Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China. [email protected].
⁸ Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China. [email protected].
⁹ Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China. [email protected].
¹⁰ Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China. [email protected].
¹¹ Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China. [email protected].
¹² Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China. [email protected].

^# Contributed equally.

Abstract

Klebsiella pneumoniae carbapenemase-producing Pseudomonas aeruginosa (KPC-PA) isolates have quickly expanded in China, especially the high-risk clone ST463. We aimed to explore the evolution of KPC-related plasmids driving ST463 clone success. Whole-genome sequencing of 1258 clinical P. aeruginosa strains (2011-2020) identified 106 ST463-PA isolates, with a KPC prevalence of 90.6%. Early on (2011-2012), ST463-PA obtained the KPC-encoding type II (pT2-KPC) or type I plasmid (pT1-KPC) to overcome carbapenem stress. Between 2012 and 2017, pT1-KPC plasmid dominated due to its lower fitness costs and IS26-driven bla_KPC amplification ability. By 2017-2020, large fragment deletions in pT1-KPC formed pT1_del-KPC plasmid. It conferred even lower fitness costs, enhanced bla_KPC-2 gene stability, and greater copy-number flexibility, while maintaining horizontal transmission ability. Consequently, pT1_del-KPC plasmid finally succeeded, making ST463 the dominant ST in China. Our findings highlight evolutionary pressures driving ST463 dominance and emphasize the need for targeted strategies to control its spread and antibiotic resistance development.

MeSH terms

Anti-Bacterial Agents / pharmacology
Bacterial Proteins / genetics
Bacterial Proteins / metabolism
China
Evolution, Molecular
Humans
Klebsiella pneumoniae / drug effects
Klebsiella pneumoniae / genetics
Microbial Sensitivity Tests
Plasmids* / genetics
Pseudomonas Infections / epidemiology
Pseudomonas Infections / microbiology
Pseudomonas aeruginosa* / drug effects
Pseudomonas aeruginosa* / enzymology
Pseudomonas aeruginosa* / genetics
Whole Genome Sequencing
beta-Lactamases* / genetics
beta-Lactamases* / metabolism

Substances

beta-Lactamases
Bacterial Proteins
carbapenemase
Anti-Bacterial Agents

Abstract

MeSH terms

Substances

Grants and funding