Description of blaKPC-carrying Escherichia coli in patients from a Brazilian hospital over a 4-year period

Klebsiella pneumoniae carbapenemase (KPC)-producing Escherichia coli are recognized by the World Health Organization as a critical group of bacterial priority pathogens of public health importance. Thus, increased understanding of the genetic characteristics of KPC-producing E. coli is required. Here, we performed a retrospective study in a Brazilian teaching-hospital to describe the genomic features linked to antimicrobial resistance, virulence, and phylogeny of 40 meropenem-resistant E. coli. All isolates carried the bla_KPC-2 gene, but amikacin, tigecycline, colistin, polymyxin B, and fosfomycin showed good activity. Molecular typing by MLST revealed 20 sequence types (STs), with a predominance of ST131. Whole-genome sequencing identified Tn4401 as a mechanism responsible for bla_KPC-2 mobilization, a variety of antimicrobial resistance and virulence genes, the predominance of pathogenic phylogroup lineages, and the grouping of genomes belonging to the same ST. KPC-producing E. coli is not a common pathogen, but few treatment alternatives are available against potentially virulent strains.