Absence of the type I-E CRISPR-Cas system in Klebsiella pneumoniae clonal complex 258 is associated with dissemination of IncF epidemic resistance plasmids in this clonal complex

Background: The pandemics caused by MDR Klebsiella pneumoniae are mostly due to the global dissemin- o - ation of high-risk clonal complex 258 (CC258) and related IncF epidemic plasmids. However, the factors Leading to the epidemiological advantages of CC258-IncF Linkage remain obscure. The Clustered Regularly Interspaced Short Palindromic Repeat (CRISPR) and CRISPR-associated protein (CRISPR-Cas) systems, providing adaptive immunity against invading DNA, play an important role in the interactions between plasmids and hosts. Objectives: To investigate the relationship between CRISPR-Cas systems and the high-risk Linkage CC258-IncF. Methods: CRISPR-Cas Loci were detected among 381 collected K. pneumoniae clinical isolates and 207 K. pneumoniae complete genomes available in GenBank. MLST was used to determine the genetic relatedness of these isolates. Nucleotide BLAST was used to search for protospacers on K. pneumoniae plasmids. Results: We observed an epidemic correlation between CRISPR-Cas Loci, CC258 and IncF plasmids. Interestingly, most type I-E CRISPR-Cas systems identified carried spacers matching the backbone regions of IncF plasmids. Conclusions: Our results suggest that the absence of type I-E CRISPR-Cas systems in K. pneumoniae CC258 is strongly associated with the dissemination of IncF epidemic plasmids, contributing to the global success of the international high-risk Linkage CC258-IncF. Our findings provide new information regarding the dissemination and evolution of the high-risk Linkage of K. pneumoniae CC258-IncF and pave the way for new strategies to 0 address the problem of antibiotic resistance.