case_images: PMC9377402_01
case_images: Phylogenetic tree based on core genome and drug resistance genes of ST196 Klebsiella quasipneumoniae. Antimicrobial resistance genes are shown in purple solid circles.
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case_images: All Qatar strains contained blaNDM-1, and one US strain (CAV1947, from hospital wastewater) co-harbored blaKPC-2 and blaKPC-3; only SBH035 contained blaNDM-7 (Figure 1). IncX3 plasmids (99.9-100% identity and 100% coverage) as well as IncX3 plasmids harboring other blaNDM alleles, for example, pHN6DS3 (blaNDM-5, MN276078), pHD6415-NDM (blaNDM-33, MZ004933), pNDM-20 (blaNDM-20, MF458176), and pM216_X3 (blaNDM-4, AP018146) (Figure S1). In pYUSBH035, blaNDM-7 was located in a region with various insertion sequence (IS) elements (IS26, IS5, ISAba125 and IS3000).
case_images: Genetic environment of multidrug resistance region in pYUSBH035 and homologous plasmids.
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case_images: This blaNDM-7 segment was inserted into umuD flanked by 3-bp DRs (5'-TGT-3') (Figure 2). This genetic context was also found in other blaNDM-carrying IncX3 plasmids, except that 925 bp of the 5'-end of ISAba15 was absent in a blaNDM-7-bearing plasmid pHZW25-P4 (CP025215) from K. pneumoniae in China (Figure 2).