Emergence of NDM-7-Producing Klebsiella quasipneumoniae subs. simillipneumoniae ST138 in a Hospital from the Northern Region of Brazil

Clinical emergent bacterial pathogens are a great threat to the global health system, chiefly Gram-negative carbapenem-resistant Enterobacterales and the <i>Klebsiella pneumoniae</i> species complex. Here, we present the molecular and phenotypic characterization of <i>Klebsiella quasipneumoniae</i> subs. <i>similipneumoniae</i> IEC57090 strain, belonging to ST138 and showing a multidrug resistance phenotype. The <i>bla</i>_NDM-7 present in one of the two resistance plasmids carried by the isolate, the antibiotic resistance genes <i>fos</i>A, <i>oqx</i>AB, and <i>acr</i>R, and gene mutations on porins <i>omp</i>K36 and <i>omp</i>K37, both associated with cephalosporin and carbapenem resistance, were detected. Virulence factors such as the clusters of type I and III fimbria, type IV pili genes, and genes associated with the K1 capsule, siderophore production, and multiple mobile genetic elements (MGE) were predicted. The emergence of silent pathogens in clinical environments highlights the importance of active research on new threads that may compromise the last resources of antimicrobials, such as carbapenems, specifically on mobile genetic elements containing carbapenemases in emergent pathogens, which can spread these antimicrobial resistance elements. This study reinforces that molecular biology vigilance can prevent outbreaks and help to better understand antimicrobial resistance and pathogens in clinical environment dynamics.