Co-Production of KPC-2 and NDM-5 in a Carbapenem-Resistant Klebsiella Pneumoniae Clinical Isolate: Genetic Insights and Risks

This study demonstrates clonal evolution of ST11 CRKP to co-produce KPC-2 and NDM-5 within a host, clustering within a prevalent epidemic lineage. Critically, we provide experimental evidence that mobilizable plasmids retaining only a partial T4SS can undergo horizontal transfer when assisted by conjugative plasmids, fundamentally expanding our understanding of resistance dissemination. The convergence of high-risk epidemiology, MDR, and novel plasmid transfer mechanisms in strains like KP3T58 necessitates enhanced surveillance and urgent molecular investigation into the transmission dynamics of these threats.