Identification of one plasmid harboring tmexCD1-toprJ1 in clinical Klebsiella pneumoniae

Two clinical <i>K. pneumoniae</i><i> </i>strains coharboring carbapenemase genes and novel <i>tmexCD1</i>-<i>toprJ1</i><i> </i>RND efflux pump were characterized here. The novel RND efflux pump gene cluster <i>tmexCD1</i>-<i>toprJ1</i><i> </i>coexisted with <i>bla</i>_NDM-1 or <i>bla</i>_KPC-2 in IncHI5-like and IncFII conjugative plasmids. This study highlights the emerging convergence of carbapenemase genes and <i>t</i><i>mexCD1</i>-<i>toprJ1</i> in typical MDR plasmids among clinical <i>K. pneumoniae</i>, which threatens treatments of CRKP infections. Epidemiology of such pathogens is warranted intensive investigations to evaluate the public health risk.