摘要
出身背景
肺炎克雷伯菌（hvKp）的高致病型主要由大毒力质粒介导。这些高毒力质粒（HVPs）似乎正在积累抗微生物耐药性基因（ARGs），并迅速转变为耐药高毒力杂交体。因此，需要研究参与这种趋同的分子机制，以控制其全球传播。
方法
在本研究中，从GenBank中检索到79个非冗余高通气质粒的完整序列，并使用生物信息学工具比较了它们的遗传特征、高通气和抗微生物耐药性模式（AMR）及其假定的传播能力。
后果
大多数HVP属于克隆复合体（CC）23和序列类型（ST）11。IncFIB和IncHI1B是最普遍的质粒复制子类型。在79个质粒中，有78个对iutA和iucA呈阳性。在77个质粒中发现了iucC、iucB和iucD基因。近26%的HVP具有潜在的结合性，其中71%携带AGR。在30%的HVP中检测到针对β-内酰胺类、碳青霉烯类、喹诺酮类、氨基糖苷类、氯霉素、四环素类和大环内酯类的ARGs。在8个质粒中发现了携带多个ARG的1类整合子和原噬菌体结构。插入序列（IS）6、IS110和IS1380似乎是ARGs传播的重要遗传元件。
结论
iucA和iutA的高患病率表明它们在实验室中具有快速准确的遗传标记来区分hvKp的强大能力。这项研究表明了可移动遗传元件（MGE）在高毒力菌株耐药性出现中的重要作用。假定的偶联杂交种的高流行率意味着在不久的将来耐多药（MDR）-hvKp菌株的发病率更高。
Abstract
Background
The hypervirulent pathotype of Klebsiella pneumoniae (hvKp) is mainly mediated by large virulent plasmids. It seems that these hypervirulent plasmids (HVPs) are accumulating antimicrobial resistance genes (ARGs) and are turning quickly into drug-resistant hypervirulent hybrids. Therefore, molecular mechanisms involved in this convergence needs to be investigated to control their global spread.

Methods
In this study, the complete sequence of 79 non-redundant hypervirulent plasmids were retrieved from GenBank and their genetic features, hypervirulence and antimicrobial resistance patterns (AMR) as well as their putative transmission capability were compared using bioinformatics tools.

Results
The majority of HVPs belonged to clonal complex (CC)23, and sequence type (ST)11. IncFIB and IncHI1B were the most prevalent plasmid replicon types. Out of 79 plasmids, 78 were positive for iutA and iucA. The iucC, iucB and iucD genes were found in 77 plasmids. Almost 26% of the HVPs were potentially conjugative of which 71% carried AGRs. ARGs against beta-lactams, carbapenems, quinolones, aminoglycosides, chloramphenicols, tetracyclines and macrolides were detected in 30% of HVPs. Class 1 integron and prophage structures harboring multiple ARGs were found in eight plasmids. Insertion sequences (IS)6, IS110 and IS1380 appeared to be important genetic elements in transmission of ARGs.

Conclusions
The high prevalence of iucA and iutA suggests their strong capability for rapid and accurate genetic markers for discrimination of hvKp in the laboratory. This study indicated the important role of mobile genetic elements (MGEs) in the emergence of drug-resistance in hypervirulent strains. The high prevalence of putative conjugative hybrids implies higher incidence of multidrug-resistant (MDR)-hvKp strains in near future.

https://link.springer.com/article/10.1186/s12941-022-00514-6