Replicon sequence typing of IncF plasmids and the genetic environments of bla _CTX-M-15 indicate multiple acquisitions of bla _CTX-M-15 in Escherichia coli and Klebsiella pneumoniae isolates from South Korea

Objectives: The purpose of this study was to investigate variations in IncF plasmids and the genetic environments of bla _CTX-M-15 in CTX-M-15-producing Escherichia coli and Klebsiella pneumoniae isolates from South Korea. Methods: A total of 56 E. coli and 15 K. pneumoniae isolates, which were previously characterized for CTX-M-15 production, sequence type by multilocus sequence typing and replicon type, were included in this study. Replicon sequence typing for IncF plasmids was performed and the genetic environments of bla _CTX-M-15 were determined using PCR and sequencing. Results: A total of 34 and 10 IncF-replicon sequence types (RSTs) were identified among the E. coli and K. pneumoniae isolates, respectively. Only eight and four IncF-RSTs were found in multiple isolates of E. coli and K. pneumoniae, respectively. No common IncF-RSTs were found between E. coli and K. pneumoniae isolates. Five and three different bla _CTX-M-15 genetic environments were identified in E. coli and K. pneumoniae isolates, respectively. Even in the same E. coli clone, diverse IncF-RSTs and bla _CTX-M-15 genetic environments were identified. Conclusions: Diverse IncF plasmids have incorporated into diverse strains of E. coli and K. pneumoniae, contributing to the spread of the CTX-M-15 extended-spectrum β-lactamase in South Korea. It can also be inferred that bla _CTX-M-15 has not been transferred directly from E. coli to K. pneumoniae.