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Objective <p>This study aimed to characterize the genomic features and possible transmission mechanisms of an extensively drug-resistant (XDR) <i>Klebsiella pneumoniae</i> (KP2024). The isolate was recovered from pelvic effusion of a postoperative colon cancer patient in Hebei, China, with a focus on the rare <i>mcr-3.11</i> gene as well as <i>blaNDM-5</i> and <i>blaCTX-M-27</i>.</p> Results <p>Genetic analysis of key resistance determinants identified three epidemiologically important plasmids: an IncFIB plasmid carrying <i>blaCTX-M-27</i> (pKP2024-1), an IncFII plasmid carrying <i>mcr-3.11</i> (pKP2024-3), and an IncX3 plasmid carrying <i>blaNDM-5</i> (pKP2024-4). Comparative genomic analysis indicated that <i>blaCTX-M-27</i> was located within a highly conserved transposition unit mediated by ISEcp1. Additionally, <i>mcr-3.11</i> and diacylglycerol kinase (<i>dgkA)</i> formed a conserved mobile genetic element, while <i>blaNDM-5</i> was located within a typical Tn3-IS3000-IS5-<i>blaNDM-5</i>-<i>bleMBL</i>-<i>trpF</i>-IS26-ISKox3 structure on the IncX3 plasmid. All these plasmids harbored complete conjugative transfer systems or mobile genetic elements, indicating a high potential for horizontal gene transfer.</p> Conclusion <p>This study reports an XDR <i>K. pneumoniae</i> co-harboring <i>mcr-3.11</i>, <i>blaNDM-5</i>, and <i>blaCTX-M-27</i>, isolated from the postoperative pelvic effusion of a colon cancer patient. Multiple key resistance genes are distributed on different types of plasmids, conferring resistance to “last-line” clinical agents such as carbapenems and colistin. The co-existence of multiple plasmids and the co-evolution of resistance genes may further increase the risk of resistance transmission, highlighting the importance of enhancing clinical surveillance for such highly resistant clones.</p>

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Genomic characterization of an extensively drug-resistant Klebsiella pneumoniae co-harboring mcr-3.11, blaNDM-5 and blaCTX-M-27 isolated from pelvic effusion in a colon cancer patient

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  • 发表日期：

    2026年5月21日

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  • Kaixuan Zhao,
  • Wei Wang,
  • Ming Ma,
  • Junhua Feng,
  • Tianyu Qi,
  • Jiajie Wang,
  • Jing He

摘要

Objective

This study aimed to characterize the genomic features and possible transmission mechanisms of an extensively drug-resistant (XDR) Klebsiella pneumoniae (KP2024). The isolate was recovered from pelvic effusion of a postoperative colon cancer patient in Hebei, China, with a focus on the rare mcr-3.11 gene as well as blaNDM-5 and blaCTX-M-27.

Results

Genetic analysis of key resistance determinants identified three epidemiologically important plasmids: an IncFIB plasmid carrying blaCTX-M-27 (pKP2024-1), an IncFII plasmid carrying mcr-3.11 (pKP2024-3), and an IncX3 plasmid carrying blaNDM-5 (pKP2024-4). Comparative genomic analysis indicated that blaCTX-M-27 was located within a highly conserved transposition unit mediated by ISEcp1. Additionally, mcr-3.11 and diacylglycerol kinase (dgkA) formed a conserved mobile genetic element, while blaNDM-5 was located within a typical Tn3-IS3000-IS5-blaNDM-5-bleMBL-trpF-IS26-ISKox3 structure on the IncX3 plasmid. All these plasmids harbored complete conjugative transfer systems or mobile genetic elements, indicating a high potential for horizontal gene transfer.

Conclusion

This study reports an XDR K. pneumoniae co-harboring mcr-3.11, blaNDM-5, and blaCTX-M-27, isolated from the postoperative pelvic effusion of a colon cancer patient. Multiple key resistance genes are distributed on different types of plasmids, conferring resistance to “last-line” clinical agents such as carbapenems and colistin. The co-existence of multiple plasmids and the co-evolution of resistance genes may further increase the risk of resistance transmission, highlighting the importance of enhancing clinical surveillance for such highly resistant clones.