Comparative Genomic Study of blaKPC-2-Carrying Multidrug-Resistant Klebsiella pneumoniae in the United Arab Emirates

Background: Whole-genome sequencing of three distinct multidrug-resistant KPC-producing Klebsiella pneumoniae isolates recovered from patients hospitalized at a tertiary-care hospital in Abu Dhabi, UAE, was performed. A comparative analysis was then performed with previously reported KPC-producing isolates from the UAE. Our goal was to identify acquired antimicrobial resistance genes (ARGs), assess their epidemiological and phylogenetic characteristics, and analyse the plasmids carrying bla _KPC-2 . Methods: Between 2017 and 2018, 162 carbapenem-resistant K. pneumoniae (CRKP) isolates were collected from four tertiary care hospitals in Abu Dhabi. Antibiotic susceptibility was determined using the Vitek2 system, and PCR was used to detect carbapenemase genes. Whole-genome sequencing of three identified bla _KPC-2 -positive isolates was performed using Illumina NovaSeq, with reads assembled via SPAdes 3.9. PlasmidSPAdes and PLACNETw were used to identify bla _KPC-2 -carrying plasmids, which were compared to previously published UAE data. Results: The three K. pneumoniae isolates belonged to sequence types ST11, ST20, and ST231, respectively. All harbored the bla _KPC-2 gene onto IncFII-type plasmids of varying sizes. A shift in the genetic landscape of bla _KPC-2 plasmids was observed, with two transposons being at the origin of this carbapenemase gene acquisition, namely Tn 1721a and Tn 4401b, the latter corresponding to the dominant platform since 2012. Conclusions: Our findings highlight the evolving genetic landscape of bla _KPC-2 -carrying plasmids in the UAE, emphasizing the increasing prevalence of IncFII plasmids and their potential role in the spread of antimicrobial resistance.