Phenotypic and genomic characteristics of clinical IMP-producing Klebsiella spp. Isolates in China

Abstract Background IMP-producing Klebsiella spp. (IMPKsp) strains have spread globally, including in China. Currently, the prevalence and genomic characterization of IMPKsp is largely unknown nationwide. Here we aimed to provide a general overview of the phenotypic and genomic characteristics of IMPKsp strains. Methods 61 IMPKsp strains were obtained from 13 provinces in China during 2016-2021. All strains were tested for their susceptibility to antimicrobial agents by the microdilution broth method and sequenced with Illumina next-generation sequencing. We performed conjugation experiments on thirteen representative strains which were also sequenced by Oxford nanopore sequencing technology to characterize bla IMP-encoding plasmids. Results We find that all IMPKsp strains display multidrug-resistant (MDR) phenotypes. All strains belong to 27 different STs. ST307 emerges as a principal IMP-producing sublineage. bla IMP-4 is found to be the major isoform, followed by bla IMP-38. Seven incompatibility types of bla IMP-encoding plasmids are identified, including IncHI5 (32/61, 52.5%), IncN-IncR (10/61, 16.4%), IncFIB(K)-HI1B (7/61, 11.5%), IncN (5/61, 8.2%), IncN-IncFII (2/61, 3.3%), IncFII (1/61, 1.6%) and IncP (1/61, 1.6%). The strains carrying IncHI5 and IncN plasmids belong to diverse ST types, indicating that these two plasmids may play an important role in the transmission of bla IMP genes among Klebsiella spp. strains. Conclusions Our results highlight that multi-clonal transmission, multiple genetic environments and plasmid types play a major role in the dissemination process of bla IMP genes among Klebsiella spp. IncHI5 type plasmids have the potential to be the main vectors mediating the spread of the bla IMP genes in Klebsiella spp.