Molecular evolution of a klebsiella pneumoniae st278 isolate harboring blandm-7 and involved in nosocomial transmission

Tarah Lynch, Liang Chen, Gisele Peirano, Dan B. Gregson, Deirdre L. Church, John Conly, Barry N. Kreiswirth, Johann D. Pitout

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


During 2013, ST278 Klebsiella pneumoniae with blaNDM-7was isolated fromthe urine (KpN01) and rectum(KpN02) of a patient inCalgary, Canada. The same strain (KpN04) was subsequently isolated from another patient in the same unit. Interestingly, a carbapenem-susceptible K. pneumoniae ST278 (KpN06) was obtained 1 month later from the blood of the second patient. Next-generation sequencing (NGS) revealed that the loss of carbapenem-resistance in KpN06 was due to a 5-kb deletion on the blaNDM-7-harboring IncX3 plasmid. In addition, an IncFIB plasmid in KpN06 had a 27-kb deletion that removed genes encoding for heavy metal resistance. Phylogenetic analysis showed that the K. pneumoniae ST278 frompatient 2 was likely a descendant of KpN02 and that KpN06 was a close progenitor of an environmental ST278. It is unclear whether KpN06 lost the blaNDM-7 gene in vivo. This study detailed the remarkable plasticity and speed of evolutionary changes in multidrug-resistant K. pneumoniae, demonstrating the highly recombinant nature of this species. It also highlights the ability of NGS to clarify molecular microevolutionary events within antibiotic-resistant organisms.

Original languageEnglish (US)
Pages (from-to)798-806
Number of pages9
JournalJournal of Infectious Diseases
Issue number5
StatePublished - Sep 1 2016

All Science Journal Classification (ASJC) codes

  • Infectious Diseases
  • Immunology and Allergy


  • BlaNDM-7
  • Carbapenemases
  • K. pneumoniae
  • Microevolution
  • Plasmid
  • ST278


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