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Genetic determinants of a clinical  Klebsiella pneumoniae  isolate (KP1814) coproducing IMP-4 and a rare ESBL gene SFO-1 was investigated. KP1814 belongs to a novel sequence type (ST) assigned to ST2270. WGS identified four circular DNA sequences in KP1814, including two multidrug-resistance (MDR) plasmids, one virulence plasmid, and one circular form. The MDR plasmid pKP1814-1 (299.9 Kb) is untypeable, and carries two large mosaic multiresistance regions (MRRs).  bla   SFO-1  and  bla   IMP-4  co-exists on MRR1, and  bla   SFO-1  is associated with an IS/Tn-independent genetic context.  bla   IMP-4  is carried by a novel In804-like integron ( intlI - bla   IMP-4 - Kl.pn.I3 - qacG2 - aacA4 - catB3 ∆) associated with a novel Tn 1696 -like transposon (designed Tn 6404 ) flanked by IS 5075 . The other MDR plasmid pKP1814-3 is a 95,701-bp IncFII plasmid, and is a hybrid of a  Shigella flexneri  plasmid pSF07201 and an  E .  coli  plasmid pCA08. All resistance genes of pKP1814-3 were detected in a ~16-kb IS 26 -flanked composite transposon carried by a Tn 5396  transposon. The circular form (18.3 Kb) was composed of two parts belonging to pKP1814-1 and pKP1814-3, respectively. The plasmid pKP1814-2, carrying multiple virulence factors, encodes IncFIB K  and IncFII K  replicons with a size of 187,349 bp. The coexistence of MDR and virulence plasmids largely enhances the bacterial fitness in the host and environment.

A novel Tn1696-like composite transposon (Tn6404) harboring bla IMP-4 in a Klebsiella pneumoniae isolate carrying a rare ESBL gene bla SFO-1