Diversity and evolutionary dynamics of carbapenemase-encoding plasmids amongst Klebsiella pneumoniae in Europe. Plasmid Diversity Amongst Klebsiella pneumoniae

The incidence of Klebsiella pneumoniae infections that are resistant to carbapenems, a last-line class of antibiotics, has increased rapidly over recent years, posing a major public health threat. The primary mechanism of carbapenem resistance is production of carbapenemase enzymes, which are most frequently encoded on plasmids by blaOXA-48-like, blaVIM-like, blaKPC-like and blaNDM-like genes. Using short-read sequence data, we previously analysed the genomes of >1700 K. pneumoniae submitted during the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE). In this study, we aimed to investigate the diversity, prevalence and transmission dynamics of carbapenemase-encoding plasmids using long-read sequencing of selected representative isolates (n=79) from this collection in combination with the short-read data.