Enterobacteriaceae isolated from patients share antibiotic resistance conferring plasmids recently acquired from those isolated from sinks in the same treatment room

Abstract

Identifying how and where pathogens acquire antibiotic resistance is crucial to developing effective strategies to limit its spread. Many bacterial species carry and share plasmids harboring antibiotic resistant genes. Plasmids are mobile genetic elements whose horizontal transmission is difficult to assess through genomic comparison due to assembly issues when using short-read sequencing alone. In this study, we use hybrid assembly to fully assemble plasmids that are shared between different Enterobacteriaceae isolated from patients and sinks in the same hospital rooms. We isolated and sequenced pairs of carbapenem resistant Enterobacter hormaechei subsp. xiangfangensis and Klebsiella pneumoniae from patients and sinks within the same hospital room. The isolate pairs share plasmids that putatively confer antibiotic resistance, including carbapenem resistance. These plasmids differ by few mutations and structural changes, while the isolates carry unique plasmids. Together, this suggests that plasmids can act as vectors of antibiotic resistance spread from sink reservoirs to patients.