Involvement of the blaCTX-M-3 gene in emergence of a peculiar resistance phenotype in Klebsiella pneumoniae

IntroductionThis study aimed to investigate the mechanism underlying a peculiar resistance phenotype in Klebsiella pneumoniae, characterized by reduced susceptibility to cefepime compared to ceftazidime.MethodsAntimicrobial susceptibility testing, plasmid conjugation experiments, whole-genome sequen...

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Main Authors: Peishan Li, Leping Yan, Jingjie Song, Chengfeng Lin, Fangyin Zeng, Shihan Zeng
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Cellular and Infection Microbiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fcimb.2025.1545157/full
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author Peishan Li
Leping Yan
Jingjie Song
Chengfeng Lin
Fangyin Zeng
Shihan Zeng
author_facet Peishan Li
Leping Yan
Jingjie Song
Chengfeng Lin
Fangyin Zeng
Shihan Zeng
author_sort Peishan Li
collection DOAJ
description IntroductionThis study aimed to investigate the mechanism underlying a peculiar resistance phenotype in Klebsiella pneumoniae, characterized by reduced susceptibility to cefepime compared to ceftazidime.MethodsAntimicrobial susceptibility testing, plasmid conjugation experiments, whole-genome sequencing, and bioinformatic analyses were employed to characterize the resistance phenotype and identify genetic determinants.ResultsA total of 20 K. pneumoniae strains exhibiting peculiar resistance phenotypes were collected and analyzed. Ten distinct sequence types (STs) were identified, including ST25 (4/20), ST967 (3/20), ST65 (2/20), ST133 (2/20), ST48 (2/20), ST353 (1/20), ST628 (1/20), ST753 (1/20), ST792 (1/20), and ST254 (1/20). All strains were resistant to FEP (MIC50 = 128 µg/mL) but not to CAZ (MIC50 = 8 µg/mL). This resistance was primarily attributed to the presence of the blaCTX-M-3 (14/20) and blaOXA-10 (3/20). Conjugation experiments demonstrated that 5 out of 14 blaCTX-M-3-positive K. pneumoniae strains successfully acquired transconjugants, which exhibited the same peculiar resistance phenotype. PCR analysis confirmed that the conjugates contained the IncFII plasmid. To further elucidate the genetic basis of the resistance phenotype, whole-genome long-read sequencing was performed on three blaCTX-M-3-positive K. pneumoniae strains. The sequencing results confirmed that blaCTX-M-3 was located on the IncFII plasmid, and analysis of its genetic environment revealed a frequent association with mobile genetic elements such as IS26, ISEcp1, and Tn3.DiscussionThe primary driver of this phenotype in K. pneumoniae is the presence of the IncFII plasmid carrying blaCTX-M-3, which contrasts with the resistance mechanisms often reported in Pseudomonas aeruginosa exhibiting similar phenotypes. This study emphasizes the critical role of plasmid-mediated resistance in the spread of multidrug resistance in K. pneumoniae and provides insights into strategies for combating resistance in these pathogens.
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spelling doaj-art-5b51c02d37ff482f9825452b10d3f6962025-08-20T03:52:47ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882025-05-011510.3389/fcimb.2025.15451571545157Involvement of the blaCTX-M-3 gene in emergence of a peculiar resistance phenotype in Klebsiella pneumoniaePeishan LiLeping YanJingjie SongChengfeng LinFangyin ZengShihan ZengIntroductionThis study aimed to investigate the mechanism underlying a peculiar resistance phenotype in Klebsiella pneumoniae, characterized by reduced susceptibility to cefepime compared to ceftazidime.MethodsAntimicrobial susceptibility testing, plasmid conjugation experiments, whole-genome sequencing, and bioinformatic analyses were employed to characterize the resistance phenotype and identify genetic determinants.ResultsA total of 20 K. pneumoniae strains exhibiting peculiar resistance phenotypes were collected and analyzed. Ten distinct sequence types (STs) were identified, including ST25 (4/20), ST967 (3/20), ST65 (2/20), ST133 (2/20), ST48 (2/20), ST353 (1/20), ST628 (1/20), ST753 (1/20), ST792 (1/20), and ST254 (1/20). All strains were resistant to FEP (MIC50 = 128 µg/mL) but not to CAZ (MIC50 = 8 µg/mL). This resistance was primarily attributed to the presence of the blaCTX-M-3 (14/20) and blaOXA-10 (3/20). Conjugation experiments demonstrated that 5 out of 14 blaCTX-M-3-positive K. pneumoniae strains successfully acquired transconjugants, which exhibited the same peculiar resistance phenotype. PCR analysis confirmed that the conjugates contained the IncFII plasmid. To further elucidate the genetic basis of the resistance phenotype, whole-genome long-read sequencing was performed on three blaCTX-M-3-positive K. pneumoniae strains. The sequencing results confirmed that blaCTX-M-3 was located on the IncFII plasmid, and analysis of its genetic environment revealed a frequent association with mobile genetic elements such as IS26, ISEcp1, and Tn3.DiscussionThe primary driver of this phenotype in K. pneumoniae is the presence of the IncFII plasmid carrying blaCTX-M-3, which contrasts with the resistance mechanisms often reported in Pseudomonas aeruginosa exhibiting similar phenotypes. This study emphasizes the critical role of plasmid-mediated resistance in the spread of multidrug resistance in K. pneumoniae and provides insights into strategies for combating resistance in these pathogens.https://www.frontiersin.org/articles/10.3389/fcimb.2025.1545157/fullCTX-M-3Klebsiella pneumoniaepeculiar resistance phenotypecefepimeceftazidime
spellingShingle Peishan Li
Leping Yan
Jingjie Song
Chengfeng Lin
Fangyin Zeng
Shihan Zeng
Involvement of the blaCTX-M-3 gene in emergence of a peculiar resistance phenotype in Klebsiella pneumoniae
Frontiers in Cellular and Infection Microbiology
CTX-M-3
Klebsiella pneumoniae
peculiar resistance phenotype
cefepime
ceftazidime
title Involvement of the blaCTX-M-3 gene in emergence of a peculiar resistance phenotype in Klebsiella pneumoniae
title_full Involvement of the blaCTX-M-3 gene in emergence of a peculiar resistance phenotype in Klebsiella pneumoniae
title_fullStr Involvement of the blaCTX-M-3 gene in emergence of a peculiar resistance phenotype in Klebsiella pneumoniae
title_full_unstemmed Involvement of the blaCTX-M-3 gene in emergence of a peculiar resistance phenotype in Klebsiella pneumoniae
title_short Involvement of the blaCTX-M-3 gene in emergence of a peculiar resistance phenotype in Klebsiella pneumoniae
title_sort involvement of the blactx m 3 gene in emergence of a peculiar resistance phenotype in klebsiella pneumoniae
topic CTX-M-3
Klebsiella pneumoniae
peculiar resistance phenotype
cefepime
ceftazidime
url https://www.frontiersin.org/articles/10.3389/fcimb.2025.1545157/full
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