Emergence and genomics of OXA-232-producing Klebsiella pneumoniae in a hospital in Yancheng, China.

Abstract Objectives This study aims to infer phylogenetic relationship of OXA-232-producing Klebsiella pneumoniae (OXA232Kp) strains collected from a Chinese hospital, and to determine the composition and genetic background of antimicrobial resistance genes (ARGs) among these strains. Methods A total of three non-duplicated OXA232Kp strains were collected from a Chinese hospital. Whole genome sequencing (WGS) was used to determined their genome sequences, and then a genomic comparison of ARG-carrying genetic elements from these three strains with related sequences were performed. Phylogenetic analysis was conducted by constructing maximum-likelihood phylogenetic tree. Results Compared with other Chinese sequence type 15 (ST15)-OXA232Kp strains, three ST15-OXA232Kp strains in this study could be divided into a single subgroup in phylogenetic relationship. The composition and genetic background of ARGs were identical in these three strains. A total of three ARG-carrying genetic elements or multidrug resistance (MDR) regions were determined, including a truncated Tn2013-like IS-based transposition unit, a unit transposition Tn6867b and a 40.9-kb MDR region. Conclusions This study reported a clonal dissemination of ST15-OXA232Kp strains carrying multiple ARGs in a Chinese hospital. A comprehensive evolutionary and genomic analysis gained a deeper understanding of OXA232Kp. Further surveillance and study should be advocated to prevent the dissemination of OXA232Kp strains in China.