Emergence of the Coexistence of mcr-1, bla_NDM-5, and bla_CTX-M-55 in Klebsiella pneumoniae ST485 Clinical Isolates in China

Figures & data

Table 1 Antimicrobial Resistance Profiling of 15 Carbapenem-Resistant Klebsiella pneumoniae Isolates

Antimicrobials	CRKP (n =15)
	No.	%
Amoxicillin/clavulanic acid	14	93.33
Piperacillin/tazobactam	14	93.33
Cefazolin	15	100.00
Ceftriaxone	15	100.00
Cefepime	15	100.00
Cefoxitin	15	100.00
Aztreonam	15	100.00
Imipenem	15	100.00
Gentamicin	9	60.00
Amikacin	7	46.67
Ciprofloxacin	15	100.00
Levofloxacin	13	86.67
Tobramycin	8	53.33
Tigecycline	2	13.33
Sulfamethoxazole	15	100.00
Polymyxin B	15	100.00

Abbreviation: CRKP, carbapenem-resistant Klebsiella pneumoniae.

Figure 1 Pulsed-field gel electrophoresis results for 15 carbapenem-resistant Klebsiella pneumoniae isolates.

Table 2 Minimum Inhibitory Concentrations of Antimicrobials Against N816, JN816, ZN816, J53, and DH5α

Antimicrobials	J53	JN816	N816	ZN816	DH5α
Piperacillin/tazobactam	≤4/4	≤4/4	>128/4	>128/4	≤4/4
Cefoxitin	16	>32	>32	>32	16
Cefazolin	≤1	>64	>64	>64	≤1
Cefepime	≤1	>16	>16	>16	≤1
Ceftriaxone	≤1	>64	>64	>64	≤1
Amoxicillin/clavulanic acid	≤0.25/4	≤0.25/4	>32/4	>32/4	≤0.25/4
Aztreonam	≤1	>32	>32	≤1	≤1
Imipenem	1	1	8	8	≤0.5
Levofloxacin	≤0.5	≤0.5	>8	≤0.5	≤0.5
Gentamicin	2	2	>16	1	1
Amikacin	≤2	≤2	≤2	≤2	≤2
Ciprofloxacin	≤0.25	≤0.25	>4	≤0.25	≤0.25
Tobramycin	≤1	≤1	8	≤1	≤1
Polymyxin B	2	4	16	≤0.5	≤0.5
Tigecycline	≤0.25	≤0.25	>8	≤0.25	≤0.25
Sulfamethoxazole	≤20	≤20	>320	≤20	≤20

Abbreviation: MICs, minimum inhibitory concentrations.

Figure 2 Structure of plasmid pMCR-1-N816 carrying mcr-1 from Klebsiella pneumoniae N816.

Figure 3 Structure of plasmid pCTX-M-55-N816 carrying bla_CTX-M-55 from Klebsiella pneumoniae N816.

Figure 4 Structure of plasmid pNDM-5-N816 carrying bla_NDM-5 from Klebsiella pneumoniae N816.