{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:09:50Z","timestamp":1789560590861,"version":"build-2803163510"},"reference-count":41,"publisher":"American Society for Microbiology","issue":"11","license":[{"start":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T00:00:00Z","timestamp":1730764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T00:00:00Z","timestamp":1730764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"the Luzhou Project","award":["2023SYF138"],"award-info":[{"award-number":["2023SYF138"]}]},{"name":"the Luzhou Project","award":["2023SYF135"],"award-info":[{"award-number":["2023SYF135"]}]},{"name":"SPDST | Sichuan Province Science and Technology Support Program","award":["2022YFQ0093"],"award-info":[{"award-number":["2022YFQ0093"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2024,11,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              Carbapenem-resistant\n              <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n              producing metallo-\u03b2-lactamase poses a major public health threat worldwide. Imipenemase often coexists with other resistance genes leading to the formation of multidrug-resistant bacteria. In this study, we describe the microbiological and genomic characteristics of the hypervirulent carbapenem-resistant\n              <jats:italic>K. pneumoniae<\/jats:italic>\n              ST20-K23 strain KPN945 harboring\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>IMP-4<\/jats:sub>\n              and\n              <jats:italic>qnrS1<\/jats:italic>\n              . The minimum inhibitory concentration of KPN945 against antimicrobials was determined by the broth microdilution method. The virulence of KPN945 was evaluated through string test, serum killing resistance, and\n              <jats:italic>Galleria mellonella<\/jats:italic>\n              larvae infection models. The transferability of pKPN945B was assessed using a conjugation test. The genome sequence characteristics of KPN945 were analyzed through whole genome sequencing, and a phylogenetic tree was constructed to evaluate the prevalence of imipenemase. Our findings showed that KPN945 was non-susceptible to \u03b2-lactam antibiotics, highly resistant to serum killing, and highly lethal to\n              <jats:italic>G. mellonella<\/jats:italic>\n              larvae. The fusion plasmid pKPN945B carried by the isolate KPN945 belonged to the IncR incompatibility group and harbored multiple drug resistance genes such as\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>IMP-4<\/jats:sub>\n              ,\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>CTX-M-14<\/jats:sub>\n              ,\n              <jats:italic>qnrS1<\/jats:italic>\n              , and\n              <jats:italic>sul2<\/jats:italic>\n              . The most important point is that the IncR plasmid is a novel plasmid that arose by the accretion of parts from different plasmids, making it transferable and with a fitness cost. Globally,\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>IMP-4<\/jats:sub>\n              is the most prevalent imipenemase subtype, with the highest isolation rates in Asia, particularly China. The spread of\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>IMP-4<\/jats:sub>\n              , especially the emergence of transferable plasmids, deserves our vigilance and prevention. Additionally, we should pay attention to the formation of hypervirulent\n              <jats:italic>K. pneumoniae<\/jats:italic>\n              mediated by non-virulent plasmids.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>IMPORTANCE<\/jats:title>\n            <jats:p>\n              Up to now, IncR replicons carrying\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>IMP-4<\/jats:sub>\n              have not been reported, and the IncR plasmids described in previous studies have been found to be non-transferrable to other bacteria through conjugation. Moreover, there have been no extensive phylogenetic analyses of strains carrying blaIMP in the published papers. The lack of data in these studies is noteworthy because blaIMP appears in the novel transferable fusion plasmid IncR. Although the IncR plasmid has no tra operon, it can still be transferred to\n              <jats:italic>Escherichia coli<\/jats:italic>\n              EC600 or\n              <jats:italic>Klebsiella<\/jats:italic>\n              pneumoniae ATCC13883 (RIF\n              <jats:sup>R<\/jats:sup>\n              ) without high fitness cost, but it only affects the MIC of imipenem.\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>IMP<\/jats:sub>\n              integrates with other resistance mechanisms leading to the formation of multidrug-resistant strains. Notably, the high prevalence of\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>IMP-4<\/jats:sub>\n              in Asia and the presence of\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>IMP-4<\/jats:sub>\n              on novel transferable IncR plasmids suggest the urgent need to monitor the emergence of such plasmids and control their spread.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/spectrum.00491-24","type":"journal-article","created":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T17:05:29Z","timestamp":1726592729000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":3,"title":["Characterization of pKPN945B, a novel transferable IncR plasmid from hypervirulent carbapenem-resistant\n            <i>Klebsiella pneumoniae<\/i>\n            , harboring\n            <i>bla<\/i>\n            <sub>IMP-4<\/sub>\n            and\n            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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingchen","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China"},{"name":"Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, Luzhou, China"},{"name":"Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, Luzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Cheng","sequence":"additional","affiliation":[{"name":"Hospital-Acquired Infection Control Department, Affiliated Hospital of Southwest Medical University, Luzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxia","family":"Jian","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China"},{"name":"Sichuan Province 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