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A total of 26  bla  IMP-4 -carrying strains of  Pseudomonas aeruginosa  and  Klebsiella pneumoniae  were isolated from 2009 to 2013 in a Chinese teaching hospital, and these strains can be assigned into multiple sequence types or allelic profiles as determined by multilocus sequence typing. Of these strains,  P. aeruginosa  P378 and  K. pneumoniae  1220 harbor the IMP-4-encoding plasmids pP378-IMP and p1220-IMP, respectively, whose complete nucleotide sequences are determined to be genetically closely related to the IncN1-type plasmid pIMP-HZ1. pP378-IMP/p1220-IMP-like plasmids are hinted to be present in all the other  bla  IMP-4 -carrying strains, indicating the dissemination of pIMP-HZ1-related plasmids among  K. pneumoniae  or  P. aeruginosa  of different genotypes in this hospital. pP378-IMP carries two distinct accessory resistance regions, a  bla  IMP-4 -carrying class 1 integron In 823b , and a truncated Tn 3 -family unit transposon ΔTn 6292 -3′ harboring the quinolone resistance gene  qnrS1 . Massive fragmentation and rearrangement of these accessory genetic contents occur among p1220-IMP and IMP-HZ1 relative to pP378-IMP . bla  IMP-4  is also present in the In 823b  remnants from p1220-IMP and IMP-HZ1, while  qnrS1  is located in a Tn 6292 -derive fragment from pIMP-HZ1 but not found in p1220-IMP. pP378-IMP represents the first fully sequenced IncN-type plasmid from  P. aeruginosa .

Dissemination of IMP-4-encoding pIMP-HZ1-related plasmids among Klebsiella pneumoniae and Pseudomonas aeruginosa in a Chinese teaching hospital