Genomic reorganization by IS26 in a blaNDM-5-bearing FII plasmid of Klebsiella pneumoniae isolated from a patient in Japan

An NDM-5-producing Klebsiella pneumoniae ST147 strain was isolated from a Japanese patient who had not travelled abroad in at least 5 years. Whole-genome sequencing revealed a genomic rearrangement in an FII plasmid harbouring bla NDM-5 due to the replicative transposition of IS26. A hypothetical structure was proposed for its ancestral plasmid, and comparative genomic analysis of the plasmid suggested the dissemination of structurally similar plasmids harbouring bla NDM-5 in Asian and Middle Eastern countries.