{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T16:10:56Z","timestamp":1785859856492,"version":"3.56.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:p>The emergence of polymyxin-resistant carbapenem-resistant <jats:italic>Klebsiella pneumoniae<\/jats:italic> (CRKP) severely limits clinical treatment options and poses a significant threat to anti-infective therapy. In this study, we investigated the genetic characteristics of an IncHI5-like plasmid co-harboring <jats:italic>bla<\/jats:italic><jats:sub>NDM\u22121<\/jats:sub> and <jats:italic>bla<\/jats:italic><jats:sub>OXA\u22121<\/jats:sub> in an <jats:italic>mcr-8.1<\/jats:italic>-positive clinical CRKP isolate using a combination of MIC testing, conjugation experiments, bacterial whole-genome sequencing, and bioinformatics analyses. The ST626 CRKP strain KP19-2581, isolated from a human clinical infection, exhibited a multidrug-resistant (MDR) phenotype. Whole-genome sequencing revealed that the colistin resistance gene <jats:italic>mcr-8.1<\/jats:italic> was located on an IncFIA\/IncFII plasmid, flanked by the conserved structure IS<jats:italic>903B<\/jats:italic>-<jats:italic>orf-mcr-8.1<\/jats:italic>-<jats:italic>orf<\/jats:italic>-IS<jats:italic>903B<\/jats:italic>. In addition, strain KP19-2581 carried a novel IncHI5-like MDR plasmid, designated pKP19-2581-367k-HI5-NDM1, which co-harbored the <jats:italic>bla<\/jats:italic><jats:sub>NDM\u22121<\/jats:sub> and <jats:italic>bla<\/jats:italic><jats:sub>OXA\u22121<\/jats:sub> genes. This plasmid contained two MDR regions, harboring a diverse array of resistance genes across multiple antibiotic classes. The dissemination of <jats:italic>bla<\/jats:italic><jats:sub>OXA\u22121<\/jats:sub> in variable region is related to the structure of class 1 integron, while IS<jats:italic>26<\/jats:italic> mediates the integration of <jats:italic>bla<\/jats:italic><jats:sub>NDM\u22121<\/jats:sub> on IncHI5-like plasmid. Notably, this is the first report of an IncHI5-like plasmid carrying both <jats:italic>bla<\/jats:italic><jats:sub>NDM\u22121<\/jats:sub> and two copies of <jats:italic>bla<\/jats:italic><jats:sub>OXA\u22121<\/jats:sub>, along with multiple resistance genes and insertion sequences. Given its potential to acquire additional resistance determinants, this plasmid may serve as a reservoir for further antimicrobial resistance evolution, underscoring the urgent need for surveillance of IncHI5 plasmids to mitigate their clinical and epidemiological impact.<\/jats:p>","DOI":"10.3389\/fmicb.2025.1601035","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T05:24:32Z","timestamp":1748323472000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Identification of an IncHI5-like plasmid co-harboring blaNDM\u22121 and blaOXA\u22121 in mcr-8.1-positive Klebsiella pneumoniae isolate"],"prefix":"10.3389","volume":"16","author":[{"given":"Xu","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyang","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shangshang","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muchen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1186\/1471-2164-12-402","article-title":"BLAST ring image generator (BRIG): simple prokaryote genome comparisons","volume":"12","author":"Alikhan","year":"2011","journal-title":"BMC Genomics"},{"key":"B2","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1016\/j.tim.2006.02.006","article-title":"Co-selection of antibiotic and metal resistance","volume":"14","author":"Baker-Austin","year":"2006","journal-title":"Trends Microbiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"741093","DOI":"10.3389\/fmicb.2021.741093","article-title":"Deciphering the epidemiological characteristics and molecular features of blaKPC-2- or blaNDM-1-positive Klebsiella pneumoniae isolates in a newly established hospital","volume":"12","author":"Chen","year":"2021","journal-title":"Front Microbiol"},{"key":"B4","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing.","year":"2021"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e0215621","DOI":"10.1128\/spectrum.02156-21","article-title":"Genomic epidemiology insights on NDM-producing pathogens revealed the pivotal role of plasmids on blaNDM transmission","volume":"10","author":"Dong","year":"2022","journal-title":"Microbiol. 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