ArticleAntimicrobial agents and chemotherapy2016
Nested Russian Doll-Like Genetic Mobility Drives Rapid Dissemination of the Carbapenem Resistance Gene blaKPC.
Article in Antimicrobial agents and chemotherapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 196 papers, 1 of them a synthesis that pooled it.
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Who cites it
196 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Are Food Animals Responsible for Transfer of Antimicrobial-Resistant Escherichia coli or Their Resistance Determinants to Human Populations? A Systematic Review.Foodborne pathogens and disease · 2018Pooled it
- The shared evolutionary capacities of plasmids and extrachromosomal DNA.Nature reviews. Genetics · 2026Review
- One Health transmission of plasmid-mediated antimicrobial resistance: genomic insights at the interface of food, animals, humans and the environment.JAC-antimicrobial resistance · 2026Review
- The pQBR mercury resistance plasmids: a model set of sympatric environmental mobile genetic elements.Microbial genomics · 2026Article
- National genomic surveillance reveals global plasmid and chromosomal dissemination routes of blanpj antimicrobials and resistance · 2026Article
- Genomic characterization of multidrug-resistant Klebsiella pneumoniae clinical isolates from India.Scientific reports · 2026Article
- Genetic diversity and occurrence of antibiotic resistance genes from community wastewater in Dhaka and Cox's Bazar, Bangladesh.One health (Amsterdam, Netherlands) · 2026Article
- Whole-genome sequencing to investigate the prevalence and transmission of multidrug-resistant Gram-negative pathogens in an adult intensive care unit in the UK.Microbial genomics · 2026Article
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- Variable chlorhexidine MICs acrossAntimicrobial agents and chemotherapy · 2026Article
- Global dissemination of optrA-mediated linezolid resistance in enterococci.The Journal of antimicrobial chemotherapy · 2026Article
- Enterobacter Species: Opportunistic Human and Plant Pathogens With Plant-Beneficial Traits.Molecular plant pathology · 2026Review
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- Prevalence, Clinical Severity, and Outcomes of Extensively Drug-Resistant and Pan-Drug-Resistant Gram-Negative Infections in a Tertiary Intensive Care Unit: A Retrospective Observational Study.Infection and drug resistance · 2026Article
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- Antibiotic Resistance inAntibiotics (Basel, Switzerland) · 2026Review
- TnCurrent research in microbial sciences · 2026Article
- Genes and physiological strategies in bacterial antibiotic resistance.Frontiers in microbiology · 2026Review
- Challenges and considerations for whole-genome-based antimicrobial resistance plasmid investigations.Antimicrobial agents and chemotherapy · 2025Review
- Chitosan mitigates pan drug resistance in citrobacter freundii exhibiting AmpC and ESBL from Egyptian livestock.Scientific reports · 2025Article
136 more citing papers are in PubMed but not listed here.
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Authors and funding
18 authors.
Funding
Abstract
The recent widespread emergence of carbapenem resistance in Enterobacteriaceae is a major public health concern, as carbapenems are a therapy of last resort against this family of common bacterial pathogens. Resistance genes can mobilize via various mechanisms, including conjugation and transposition; however, the importance of this mobility in short-term evolution, such as within nosocomial outbreaks, is unknown. Using a combination of short- and long-read whole-genome sequencing of 281 blaKPC-positive Enterobacteriaceae isolates from a single hospital over 5 years, we demonstrate rapid dissemination of this carbapenem resistance gene to multiple species, strains, and plasmids. Mobility of blaKPC occurs at multiple nested genetic levels, with transmission of blaKPC strains between individuals, frequent transfer of blaKPC plasmids between strains/species, and frequent transposition of blaKPC transposon Tn4401 between plasmids. We also identify a common insertion site for Tn4401 within various Tn2-like elements, suggesting that homologous recombination between Tn2-like elements has enhanced the spread of Tn4401 between different plasmid vectors. Furthermore, while short-read sequencing has known limitations for plasmid assembly, various studies have attempted to overcome this by the use of reference-based methods. We also demonstrate that, as a consequence of the genetic mobility observed in this study, plasmid structures can be extremely dynamic, and therefore these reference-based methods, as well as traditional partial typing methods, can produce very misleading conclusions. Overall, our findings demonstrate that nonclonal resistance gene dissemination can be extremely rapid, presenting significant challenges for public health surveillance and achieving effective control of antibiotic resistance.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.