Emergence and dissemination of an IncC plasmid co-harbouring bla _KPC-2, bla _NDM-1 and bla _VIM-24 carbapenemase genes across multiple Gram-negative species in Colombia.

Authors

Roberto Sierra, Betsy Castro, Elsa De La Cadena, Laura J Rojas, Juan Carlos García-Betancur, Mélanie Roch, Steven M Marshall, Nalleth Bolaño-Ardila, Susan D Rudin, Janneth J Escobar-Arcos, Clara J Salazar-Montes, Belkis Palacio-Villalba, Elizabeth Paz, Robert A Bonomo, María Virginia Villegas, Diego O Andrey

Published in

JAC-antimicrobial resistance. Volume 8. Issue 5. Pages dlag222. Epub Oct 16, 2026.

Abstract

Carbapenem-resistant Gram-negative bacilli (CRGNB) pose a public health threat, increasingly driven by plasmid-mediated dissemination of carbapenemase genes. As part of a Colombian genomic monitoring programme, we aimed to characterize CRGNB co-harbouring multiple carbapenemase genes and determine their genetic context.
We screened 832 carbapenem-resistant isolates collected during 2011-2023 using carbapenemase-targeted qPCR. Ten isolates co-harbouring bla _KPC, bla _NDM and bla _VIM underwent antimicrobial susceptibility testing, long-read whole-genome sequencing, comparative genomics and conjugation assays.
Nine Enterobacterales isolates and one Aeromonas caviae isolate from unrelated patients in geographically distant Colombian hospitals carried closely related IncC plasmids ranging from 160 to 317 kb. These plasmids co-harboured bla _KPC-2, bla _NDM-1 and bla _VIM-24 within three conserved multidrug resistance regions, including a Tn21-associated region carrying bla _NDM-1 and bla _VIM-24 and a Tn6454-associated bla _KPC-2 platform, alongside class 1 integrons, insertion sequences and multiple additional antimicrobial resistance determinants. The ten isolates were resistant to multiple β-lactam/β-lactamase inhibitor combinations, and five were cefiderocol resistant. Aztreonam/avibactam remained active against all isolates; colistin resistance was confined to intrinsically resistant Providencia rettgeri and Serratia sarumanii. Conjugation assays demonstrated plasmid transfer to Escherichia coli J53, and sequencing confirmed transfer of a 179 kb IncC plasmid with functional conjugation machinery. Comparative genomic analysis showed a highly conserved IncC plasmid backbone across multiple species, supporting broad dissemination of this resistance platform.
This first report of a single plasmid co-harbouring three carbapenemase genes. This finding highlights a concerning mechanism for interspecies dissemination of MDR Gram-negative pathogens and underscores the importance of long-read genomic surveillance focused on high-risk plasmids.

PMID:
42891109
Bibliographic data and abstract were imported from PubMed on 18 Oct 2026.

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