In vivo Emergence of Colistin and Tigecycline Resistance in Carbapenem-Resistant Hypervirulent Klebsiella pneumoniae During Antibiotics Treatment

• DOI: 10.3389/fmicb.2021.702956
• Publication Date: 2021-09-16T05:22:24Z
• Authors: Jiawei Chen; Yu Zeng; Rong Zhang; Jiachang Cai
• Keywords: Tigecycline; Colistin; Polymyxin

Three carbapenem-resistant Klebsiella pneumoniae (CRKP; strains KP-426, KP-C76, and KP-CT77) were isolated from a patient with severe burns during the treatment of colistin tigecycline. Single-nucleotide polymorphism typing showed that three ST11 CRKP clonally related. isolates harbored same set antimicrobial resistance genes. bla KPC-2 , SHV-12 TEM-1 rmtB genes located on 128,928-bp IncFII/IncR plasmid. Tet (A), catA2 sul2 dfrA14 plasmid an unknown Inc-type. SHV-11 fosA aadA2 chromosomal An IS 1 Kpn14 found in promoter region mgrB gene two colistin-resistant CRKP, K. KP-CT77, respectively. A novel amino acid substitution, G300E, was identified type Tet(A) variant KP-CT77 which exhibited high-level tigecycline compared to KP-426 KP-C76 (MIC 32, 4, 4mg/l, respectively). Conjugation cloning experiments confirmed mutated resulted 4-fold increase minimal inhibitory concentration (MIC) Escherichia coli . belonged K64 serotype possessed similar IncHI1B/repB virulence carrying rmpA rmpA2 iucABCDiutA The survival rates Galleria Mellonella injected 4.2, 20.8, 8.3%, emergence hypervirulent posed serious threat clinical anti-infective therapy. G300E mutation, conferred significantly elevated MIC conjugative plasmid, needs attention.