Abstract
Phenotypic and genomic characterization of a KPC-2 and MCR-1.27 producing Klebsiella pneumoniae strain isolated from a pediatric patient at an oncologic hospital in Belém, Pará State, Brazilian Amazon region. Antibiotic susceptibility test, whole genome sequencing and in silico analysis were used to characterize the bacterial isolate (IEC 48020) received in the Evandro Chagas Institute. The isolate was resistant to carbapenens, colistin, polymyxin B and several other antimicrobials, and was susceptible in vitro just to tigecycline, classified as an extensively drug resistance phenotype. Genomic analysis revealed IEC48020 strain belonged to sequence type 11, clonal complex 258 high-risk clone and the presence of eight plasmids, two of them harboring mcr-1.27 and blaKPC-2 genes, and the presence of virulence-related genes encoding yersiniabactin, phospholipase D and traT genes. The presence and dissemination of high-risk clone bacteria with high disseminating plasmids containing antibiotic resistance genes for last resources antibiotics treatment options is a threat to the health care system and demands efforts in surveillance and epidemiological research for better knowledge of the actual situation of antibiotic resistance in health care system, especially in Amazon region, Brazil.
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