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2015 ; 5
(ä): 15082
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Stepwise evolution of pandrug-resistance in Klebsiella pneumoniae
#MMPMID26478520
Zowawi HM
; Forde BM
; Alfaresi M
; Alzarouni A
; Farahat Y
; Chong TM
; Yin WF
; Chan KG
; Li J
; Schembri MA
; Beatson SA
; Paterson DL
Sci Rep
2015[Oct]; 5
(ä): 15082
PMID26478520
show ga
Carbapenem resistant Enterobacteriaceae (CRE) pose an urgent risk to global human
health. CRE that are non-susceptible to all commercially available antibiotics
threaten to return us to the pre-antibiotic era. Using Single Molecule Real Time
(SMRT) sequencing we determined the complete genome of a pandrug-resistant
Klebsiella pneumoniae isolate, representing the first complete genome sequence of
CRE resistant to all commercially available antibiotics. The precise location of
acquired antibiotic resistance elements, including mobile elements carrying genes
for the OXA-181 carbapenemase, were defined. Intriguingly, we identified three
chromosomal copies of an ISEcp1-bla(OXA-181) mobile element, one of which has
disrupted the mgrB regulatory gene, accounting for resistance to colistin. Our
findings provide the first description of pandrug-resistant CRE at the genomic
level, and reveal the critical role of mobile resistance elements in accelerating
the emergence of resistance to other last resort antibiotics.
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