Co-carriage of Plasmid NDM and Chromosomal KPC in Klebsiella pneumoniae ST255 Human Wound Isolate in Brazil.

Multidrug-resistant K. pneumoniae is one of the main causes of hospital-acquired infections worldwide and frequently carries antimicrobial resistance genes in moving elements. In this study, we described a K. pneumoniae clinical isolate carrying simultaneous chromosomal bla KPC , and plasmid-mediated bla NDM and bla OXA-9 . The isolate is multidrug-resistant and belongs to ST 225. While bla KPC were identified in the chromosome, the bla NDM was mediated by IncFII(K) plasmid and the bla OXA-9, in a IncFIB(K) plasmid. The bla KPC context was composed by Tn4401 transposon and two insertion sequences ISKpn6 and ISKpn7. The co-production of diverse ß-lactamases brings an alert about a new adaptive profile of K. pneumoniae strains and their dissemination in the hospital-acquired infectious.