Co-harboring bla KPC-2 and bla IMP-4 on an IncP Plasmid in A Clinical Isolate of Klebsiella pneumoniae - Shanghai Municipality, China, 2023.

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a major threat to global health. The co-production of multiple carbapenemases has emerged as a critical concern, further limiting the effectiveness of last-resort antibiotics such as ceftazidime-avibactam.

WHAT IS ADDED BY THIS REPORT?: This study identifies an IncP6 plasmid co-harboring both bla KPC-2 and bla IMP-4 in a clinical isolate of K. pneumoniae. Comprehensive genomic analysis reveals a complex plasmid structure shaped by recombination events and highlights its potential for mobilization, underscoring the heightened risk of carbapenem resistance.

WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: The emergence and diversification of plasmids co-harboring distinct carbapenemase genes highlight the urgent need for comprehensive genomic surveillance, stringent infection control protocols, and judicious antimicrobial management. These measures are essential to curtail the spread and evolution of multidrug-resistant organisms, which pose a substantial threat to public health globally.