Isolation of Hv-CRKP with co-production of three carbapenemases ( bla KPC , bla OXA-181 or OXA-232 , and bla NDM-1 ) and a virulence plasmid: a study from a Chinese tertiary hospital.

In our investigation, we have observed the emergence of hv-CRKP carrying genes, which identified two genetic relationships: clonal transmission and plasmid transmission. PBRT analysis showed that these genes were mainly carried on ColE-type, IncF, and IncX3 plasmids. These isolates have been shown to be hypervirulent and . Additionally, eight clinical isolates of hv-CRKP were identified as carrying three carbapenem-resistant genes (, , and ) and carrying a pLVPK-like virulent plasmid. Hence, our findings highlight the need for further investigation and active surveillance of hypervirulent OXA-48-like producing Hv-CRKP isolates to control their transmission.