CRISPR-Cas Dynamics in Carbapenem-Resistant and Carbapenem-Susceptible <i>Klebsiella pneumoniae</i> Clinical Isolates from a Croatian Tertiary Hospital

(1) Background: CRISPR-Cas systems provide adaptive immunity against mobile genetic elements (MGEs) carrying antimicrobial resistance (AMR) genes. Carbapenem-resistant (CR) <i>Klebsiella pneumoniae</i> is a major public health concern, and the role of CRISPR-Cas in its resistance is unde...

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Main Authors: Ivana Jurić, Marko Jelić, Manda Markanović, Lucija Kanižaj, Zrinka Bošnjak, Ana Budimir, Tomislav Kuliš, Arjana Tambić-Andrašević, Ivana Ivančić-Baće, Ivana Mareković
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Pathogens
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Online Access:https://www.mdpi.com/2076-0817/14/6/604
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Summary:(1) Background: CRISPR-Cas systems provide adaptive immunity against mobile genetic elements (MGEs) carrying antimicrobial resistance (AMR) genes. Carbapenem-resistant (CR) <i>Klebsiella pneumoniae</i> is a major public health concern, and the role of CRISPR-Cas in its resistance is understudied. This study explored CRISPR-Cas associations with multidrug resistance in clinical <i>K. pneumoniae</i>. (2) Methods: 400 <i>K. pneumoniae</i> isolates (200 CR and 200 carbapenem susceptible (CS)) were analyzed. Carbapenemase genes (<i>bla</i><sub>OXA-48</sub>, <i>bla</i><sub>NDM-1</sub>, <i>bla</i><sub>KPC-2</sub>), <i>cas1</i>, <i>rpoB</i>, and CRISPR1-3 loci were identified by PCR, while only CRISPR loci were sequenced. Genetic relatedness was assessed via PFGE, MLST, and spacer analysis. Statistical analysis utilized chi-squared and Fisher’s exact tests. (3) Results: CRISPR-Cas was present in 15.8% of isolates, mainly subtypes I-E and I-E* (93.3%), with CRISPR3 loci showing the greatest spacer diversity. Clonal complexes ST14/15/101 (CR) and ST35 (CS) were identified. <i>bla</i><sub>OXA-48</sub> was linked to CRISPR-Cas-negative strains, while <i>bla</i><sub>NDM-1</sub> and <i>bla</i><sub>KPC-2</sub> were more frequent in CRISPR-Cas-positive strains (<i>p</i> < 0.0001). Imipenem/relebactam resistance was higher in CRISPR-Cas-negative isolates. (4) Conclusions: <i>K. pneumoniae</i> CRISPR-Cas systems correlate with specific carbapenemase profiles, suggesting pressure against <i>bla</i><sub>OXA-48</sub> acquisition. The coexistence of I-E and I-E* subtypes highlight synergies in targeting MGEs. CRISPR loci could be tools for subtyping organisms following MLST.
ISSN:2076-0817