Background: A rare member of metallo-β-lactamases genes, bla _SIM-1 carried by a 316-kb plasmid designated pSIM-1-BJ01 was isolated from a clinical cephalosporins- and carbapenem-resistant Klebsiella pneumoniae  13624. This is the first sequence report of a transferable bla _SIM-1-carrying conjugative plasmid isolated from K. pneumoniae .
Purpose: The sequence analysis of pSIM-1-BJ01 will help us to identify genes responsible for conjugation, plasmid maintenance and drug resistance, to understand the evolution and control the dissemination of resistance plasmids.
Patients and methods: K. pneumoniae  13624 was isolated from the urine specimen of a patient. Bacterial genomic DNA was sequenced with PacBio RSII platform.
Results: Most of the pSIM-1-BJ01 backbone matches that of pRJA166a, which was isolated from a clinical hypervirulent K. pneumoniae  ST23 strain at Shanghai, China, recently. The highly homologous backbones between the two plasmids imply the close relationship of evolution. Two different multidrug-resistant regions both carrying the class 1 integrons with different resistance genes have been assembled into the pSIM-1-BJ01. Besides, the other two resistance plasmids, pKP13624-1 carrying bla _TEM-1 and bla _CTX-M-15 and pKP13624-2 carrying bla _CTX-M-14 and bla _LAP-2 were also identified.
Conclusion: The emergence of the bla _SIM-1-carrying IncHI1B pSIM-1-BJ01 suggests the spread of bla _SIM among Enterobacteriaceae is possible. We should pay more attention to supervise and control the dissemination of hypervirulent carbapenem-resistant K. pneumonia  in public hospitals.
Keywords: SIM-1, carbapenemase, Klebsiella pneumoniae , multidrug-resistant, China