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Sci Rep. 2015 Oct 19;5:15082. doi: 10.1038/srep15082.

Stepwise evolution of pandrug-resistance in Klebsiella pneumoniae.

Author information

1
The University of Queensland, Centre for Clinical Research (UQCCR), Herston QLD 4029, Australia.
2
Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia.
3
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
4
World Health Organization Collaborating Centre for Infection Prevention and Control, and the Gulf Cooperation Council Center for Infection Control, Riyadh, Saudi Arabia.
5
School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD 4072, Australia.
6
Pathology and Laboratory Medicine Department at Sheikh Khalifa General Hospital, Umm Al Quwain, United Arab Emirates.
7
Urology Department, Sheikh Khalifa General Hospital, Umm Al Quwain, United Arab Emirates.
8
Division of Genetics and Molecular Biology, Institute of Biological Sciences, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia.
9
Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia.

Abstract

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.

PMID:
26478520
PMCID:
PMC4609946
DOI:
10.1038/srep15082
[Indexed for MEDLINE]
Free PMC Article

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