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This work integrates local and global surveillance to analyze nine blaIMP-4-positive CRECs from 94 isolates collected at four tertiary hospitals in Zhejiang, China (2017–2024). Whole-genome sequencing with antimicrobial susceptibility, plasmid transfer, stability, and fitness assays shows multidrug resistance with susceptibility to colistin, tigecycline, and amikacin, diverse sequence types, similar IncN plasmids with high conjugation and low fitness cost, plus correlating resistance gene–replicon patterns, supporting plasmid-driven dissemination.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/global-epidemiological-and-genetic-characteristics-of-carbapenem-resistant-escherichia-coli-carrying-blaimp/446755/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/global-epidemiological-and-genetic-characteristics-of-carbapenem-resistant-escherichia-coli-carrying-blaimp/446755.png","ImageObject",300,407,{"name":92,"@type":93},"Franzy","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-08","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the main focus of the study on blaIMP-positive CRECs?","Question",{"text":112,"@type":113},"The study characterizes the genomic and epidemiological features of blaIMP-positive carbapenem-resistant Escherichia coli by integrating local hospital data with global surveillance results.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What were the key phenotypic and genomic findings for the nine blaIMP-4-positive isolates?",{"text":117,"@type":113},"The isolates were multidrug-resistant but susceptible to colistin, tigecycline, and amikacin, and they showed seven diverse sequence types with high-risk ST1193 clones first detected.",{"name":119,"@type":110,"acceptedAnswer":120},"Why do IncN plasmids receive particular attention in the study?",{"text":121,"@type":113},"The work highlights that IncN plasmids carry blaIMP with strong transferability, high stability after 100 generations, and minimal fitness cost, enabling regional and global dissemination.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},446755,1790767734,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":56,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},2336478945519,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","| Open Peer Review | Bacteriology | Research Article  \nGlobal epidemiological and genetic characteristics of carbapenem-resistant Escherichia coli carrying blaIMP  \nYueyue Hu,1,2 Chengjin Wu,2 Jiayao Yao,2 Jingyi Guo,2 Jie Sheng,2 Xinru Wang,2 Longjie Zhou,2 Xinyan Tang,2 Haotian Xu,2 Yunsong Yu,1,2 Xi Li,1,2 Xinhong Han3  \nAUTHOR AFFILIATIONS See affiliation list on p. 16.  \nABSTRACT Carbapenem-resistant Escherichia coli (CREC) is a serious global health threat. While blaNDM-positive and blaKPC-positive CRECs are well-characterized, the genomic and epidemiological features of blaIMP-positive CRECs remain poorly understood. This study provides a comprehensive analysis of blaIMP-positive CRECs by integrating local and global surveillance data. We characterized nine blaIMP-4-positive CRECs from 94 CRECs collected from four tertiary hospitals in Zhejiang, China (2017– 2024), using whole-genome sequencing and assays for antimicrobial susceptibility, plasmid transfer, stability, and fitness. The nine isolates were multidrug-resistant but susceptible to colistin, tigecycline, and amikacin. Seven diverse sequence types (STs) were identified, with high-risk ST1193 clones being first detected. The isolates had similar blaIMP-carrying IncN plasmids with high conjugation frequencies (5 .3 × 10−2 to 8.7 × 10−1), 100% stability after 100 generations, and minimal fitness cost, facilitating regional dissemination. In addition to plasmids, other mobile genetic elements, like class 1 integrons, transposons, and insertion sequences, can also facilitate the horizontal transfer of blaIMP genes. Global analysis of 340 blaIMP-positive CRECs revealed high genetic diversity (82 STs), with ST131 predominant (36.18%) . Clonal spread was observed for ST131 and ST216 . Significant positive correlation existed between antibiotic resistance genes and plasmid replicons (r = 0.5205, P \u003C 0.001), highlighting plasmids’role in resistance transmission. China, Japan, and Australia were the top 3 contributing countries, which also showed relatively diverse resistance genes but similar virulence factors. These findings emphasize the evolving risk of blaIMP-positive CRECs and underscore the need for sustained genomic surveillance.  \nIMPORTANCE Compared with blaNDM-positive and blaKPC-positive carbapenem-resistant Escherichia coli (CREC), blaIMP-positive CRECs are often overlooked. This study emphasized IncN plasmids, which, with their strong transferability, stability, and low fitness cost, can serve as vectors for the widespread dissemination of blaIMP genes. Additionally, the study elucidated the global epidemiological status, transmission features, and potential threats of blaIMP-positive CRECs through a large-scale analysis of publicly available genomic data. These findings not only facilitate a better understanding of the genetic dynamics and transmission pathways of blaIMP but also help develop effective regulatory measures and antibiotic stewardship programs to alleviate the increasingly severe burden of antimicrobial resistance.  \nKEYWORDS blaIMP, IncN plasmid, Escherichia coli, multidrug-resistant, genomic epidemiology  \nC arbapenems, with their good permeability and strong antimicrobial activity,  \nwere often used to treat serious infections with multidrug-resistant Gram-negative organisms (1) . However, in recent years, the worldwide overuse of β-lactam  \nEditor Haifang Zhang, Second Affiliated Hospital of Soochow, Suzhou, China  \nPeer Reviewer Fuping Hu, Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China  \nAddress correspondence to Xinhong Han, [hanxh@zju.edu.cn](hanxh@zju.edu.cn), Xi Li, lixi_061 [1@163.com](1@163.com), or Yunsong Yu, [yvys119@zju.edu.cn](yvys119@zju.edu.cn).  \nYueyue Hu and Chengjin Wu contributed equally to this article. The co-first authors order was determined based on mutual agreement upon by the authors  \ndrugs (especially carbapenems) has led to increasing reports of carbapenem-resistant Enterobacteriac","cbCaiiAGA7cKw6VX","https://ap.wps.com/l/cbCaiiAGA7cKw6VX","pdf",9953356,"English","# Abstract\n## Study design and isolates\n## Genomic features and plasmid transfer\n## Global analysis and epidemiology\n## Implications for surveillance and stewardship","[{\"question\":\"What is the main focus of the study on blaIMP-positive CRECs?\",\"answer\":\"The study characterizes the genomic and epidemiological features of blaIMP-positive carbapenem-resistant Escherichia coli by integrating local hospital data with global surveillance results.\"},{\"question\":\"What were the key phenotypic and genomic findings for the nine blaIMP-4-positive isolates?\",\"answer\":\"The isolates were multidrug-resistant but susceptible to colistin, tigecycline, and amikacin, and they showed seven diverse sequence types with high-risk ST1193 clones first detected.\"},{\"question\":\"Why do IncN plasmids receive particular attention in the study?\",\"answer\":\"The work highlights that IncN plasmids carry blaIMP with strong transferability, high stability after 100 generations, and minimal fitness cost, enabling regional and global dissemination.\"}]","Global epidemiological and genetic characteristics of carbapenem-resistant Escherichia coli carrying blaIMP | PDF",1790717069,48]