Characterization of genome-wide transpositions induced by colistin exposure in multi-drug-resistant Klebsiella pneumoniae.

Colistin is one of the last-line antibiotics against multi-drug-resistant (MDR) gram-negative pathogens, such as Klebsiella pneumoniae. Using long-read sequencing, we observed remarkable genome-wide transposition events in MDR K. pneumoniae exposed to colistin in patients receiving treatment for respiratory infections or as part of selective decolonization strategies and further confirmed these on in vitro selection experiments. These data add yet another dimension to the role of antibiotics in mediating specific processes in bacteria beyond antibiotic resistance.CLINICAL TRIALSThis study is registered with ClinicalTrials.gov as NCT02208154.