摘要
目标
高风险克隆的产碳青霉烯酶大肠杆菌谱系在全球范围内的传播对公共卫生构成了挑战。这项工作的目的是研究来自我们机构的肺炎克雷伯菌碳青霉烯酶（KPC）产生大肠杆菌的耐多药定殖菌株的基因组特征。
方法
全基因组测序由Illumina MiSeq-I完成，并使用SPAdes实现从头组装。使用ResFinder、AMRFinder、ISFinder、PlasmidFinder、MOB套件、VirulenceFinder和IntegronFinder分析抗性体、移动体、质粒、病毒群和整合子。序列类型（ST）通过pubMLST和BIGSdb数据库进行鉴定。还进行了偶联分析。
后果
从直肠拭子样本中分离出大肠杆菌HA25pEc，该样本是在医院流行病学监测方案的框架内采集的，用于检测产碳青霉烯酶的肠杆菌。大肠杆菌HA25pEc对应于来自定植患者的ST648在拉丁美洲共携带blaKPC-2和blaCTX-M-15的第一份报告。它有19个抗生素抗性基因（ARGs），包括blaKPC-2，位于Tn4401a亚型上。缀合分析显示，在我们的实验条件下，blaKPC-2没有通过缀合转移到大肠杆菌J53。
结论
大肠杆菌ST648以前曾在世界各地的伴侣和农场动物以及医院和社区获得性感染中检测到。尽管很少被报道为KPC生产商，但我们在对包括blaCTX-M-15在内的几种获得性ARGs进行培养监测时发现，该克隆有可能在全球范围内传播对β-内酰胺的极端耐药性。这些数据加强了进行分子监测的重要性，以确定宿主，并警告新的国际克隆在携带碳青霉烯酶的患者中传播。
ABSTRACT
Objectives
The worldwide dissemination of carbapenemase-producing Escherichia coli lineages belonging to high-risk clones poses a challenging public health menace. The aim of this work was to investigate genomic features of a colonizing multidrug-resistant strain of Klebsiella pneumoniae carbapenemase (KPC)-producing E. coli from our institution.

Methods
Whole-genome sequencing was done by Illumina MiSeq-I, and de novo assembly was achieved using SPAdes. Resistome, mobilome, plasmids, virulome, and integrons were analysed using ResFinder, AMRFinder, ISFinder, PlasmidFinder, MOB-suite, VirulenceFinder, and IntegronFinder. Sequence types (STs) were identified with pubMLST and BIGSdb databases. Conjugation assays were also performed.

Results
Escherichia coli HA25pEc was isolated from a rectal swab sample taken within the framework of the hospital epidemiological surveillance protocol for detection of carbapenemase-producing Enterobacterales. Escherichia coli HA25pEc corresponded to the first report of ST648 co-harbouring blaKPC-2 and blaCTX-M-15 in Latin America from a colonized patient. It had 19 antibiotic resistance genes (ARGs), including blaKPC-2, located on a Tn4401a isoform. Conjugation assays revealed that blaKPC-2 was not transferred by conjugation to E. coli J53 under our experimental conditions.

Conclusion
Escherichia coli ST648 has been detected previously in companion and farm animals as well as in hospital- and community-acquired infections worldwide. Although scarcely reported as KPC-producers, our finding in a culture surveillance with several acquired ARGs, including blaCTX-M-15, alerts the potential of this clone for worldwide unnoticed spreading of extreme drug resistance to β-lactams. These data reinforce the importance of carrying out molecular surveillance to identify reservoirs and warn about the dissemination of new international clones in carbapenemase-bearing patients.

https://www.sciencedirect.com/science/article/pii/S221371652300005X