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Klebsiella pneumoniae carbapenemase (KPC) actively hydrolyzes carbapenems, antibiotics often used a last-line treatment for multidrug-resistant bacteria. KPC clinical relevance resides in its widespread dissemination. In this work, we report the genomic context of KPC coding genes bla  KPC-2 , bla  KPC-3 and bla  KPC-30 in multidrug-resistant Klebsiella  pneumoniae isolates from Brazil. Plasmids harboring bla  KPC-3 and bla  KPC-30 were identified. Fifteen additional carbapenem-resistant K. pneumoniae isolates were selected from the same tertiary hospital, collected over a period of 8 years. Their genomes were sequenced in order to evaluate the prevalence and dissemination of bla  KPC -harboring plasmids. We found that bla  KPC genes were mostly carried by one of two isoforms of transposon Tn 4401 (Tn 4401 a or Tn 4401 b) that were predominantly located on plasmids highly similar to the previously described plasmid pKPC_FCF3SP (IncN). The identified pKPC_FCF3SP-like plasmids carried either bla  KPC-2 or bla  KPC-30 . Two K. pneumoniae isolates harbored pKpQIL-like (IncFII) plasmids, only recently identified in Brazil; one of them harbored bla  KPC-3 in a Tn 4401 a transposon. Underlining the risk of horizontal spread of KPC coding genes, this study reports the prevalence of bla  KPC-2 and the recent spread of bla  KPC-3, and bla  KPC-30 , in association with different isoforms of Tn 4401 , together with high synteny of plasmid backbones among isolates studied here and in comparison with previous reports.

Prevalence of blaKPC-2, blaKPC-3 and blaKPC-30—Carrying Plasmids in Klebsiella pneumoniae Isolated in a Brazilian Hospital