Acquisition of a stable and transferable plasmid coharbouring hypervirulence and MDR genes with low fitness cost: Accelerating the dissemination of ST11-KL64 CR-HvKP

•A fusion plasmid(pS130–4) co-carrying hypervirulence and multidrug resistance genes identified in clinical ST11-KL64 carbapenem-resistant Klebsiella pneumoniae isolates in china.•This plasmid could be successfully transconjugated into other enterobacteriaceae with low fitness cost and high stability.•This plasmid may amplify the risk associated with the spread of carbapenem-resistant hypervirulent K. pneumoniae. This study aimed to delineate the ability of a plasmid, pS130–4, which harboured both hypervirulence and multidrug resistance genes, to disseminate within Klebsiella pneumoniae, as well as its potential formation mechanism. We employed whole-genome sequencing to decipher the genetic architecture of pS130–4. Its capability to conjugate and transfer was assessed through a series of experiments, including plasmid stability, competitive growth, and growth curve analysis. Its expression stability was further evaluated using drug sensitivity, larval survival, and biofilm formation tests. pS130–4 contained four intact modules typical of self-transmissible plasmids. BLAST analysis revealed a sequence identity exceeding 90% with other plasmids from a variety of hosts, suggesting its broad prevalence. Our findings indicated the plasmid's formation resulted from IS26-mediated recombination, leading us to propose a model detailing the creation of this conjugative fusion plasmid housing both blaKPC-2 and hypervirulence genes. Our conjugation experiments established that pS130–4, when present in the clinical strain S130, was self-transmissible with an estimated efficiency between 10−5 and 10−4. Remarkably, pS130–4 showcased a 90% retention rate and did not impede the growth of host bacteria. Galleria mellonella larval infection assay demonstrated that S130 had pronounced toxicity when juxtaposed with high-virulence control strain NTUH-K2044 and low-toxicity control strain ATCC700603. Furthermore, pS130–4′s virulence remained intact postconjugation. A fusion plasmid, encompassing both hypervirulence and multidrug resistance genes, was viable within K. pneumoniae ST11-KL64 and incurred minimal fitness costs. These insights underscored the criticality of rigorous monitoring to pre-empt the escalation and distribution of this formidable super-plasmid.