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Background: A rare member of metallo-β-lactamases genes, bla  SIM-1 , carried by a 316-kb plasmid designated pSIM-1-BJ01 was isolated from a clinical cephalosporins- and carbapenem-resistant Klebsiella  pneumoniae 13624. This is the first sequence report of a transferable bla  SIM-1 -carrying conjugative plasmid isolated from K. pneumoniae . Purpose: The sequence analysis of pSIM-1-BJ01 will help us to identify genes responsible for conjugation, plasmid maintenance and drug resistance, to understand the evolution and control the dissemination of resistance plasmids. Patients and methods:  K. pneumoniae 13624 was isolated from the urine specimen of a patient. Bacterial genomic DNA was sequenced with PacBio RSII platform. Results: Most of the pSIM-1-BJ01 backbone matches that of pRJA166a, which was isolated from a clinical hypervirulent K. pneumoniae ST23 strain at Shanghai, China, recently. The highly homologous backbones between the two plasmids imply the close relationship of evolution. Two different multidrug-resistant regions both carrying the class 1 integrons with different resistance genes have been assembled into the pSIM-1-BJ01. Besides, the other two resistance plasmids, pKP13624-1 carrying bla  TEM-1 and bla  CTX-M-15 and pKP13624-2 carrying bla  CTX-M-14 and bla  LAP-2 were also identified. Conclusion: The emergence of the bla  SIM-1 -carrying IncHI1B pSIM-1-BJ01 suggests the spread of bla  SIM among Enterobacteriaceae is possible. We should pay more attention to supervise and control the dissemination of hypervirulent carbapenem-resistant K. pneumonia in public hospitals.

infection and drug resistance

&lt;p&gt;The first report of a novel IncHI1B &lt;em&gt;bla&lt;/em&gt;&lt;sub&gt;SIM-1&lt;/sub&gt;-carrying megaplasmid pSIM-1-BJ01 from a clinical &lt;em&gt;Klebsiella pneumoniae&lt;/em&gt; isolate&lt;/p&gt;