Emergence of New Delhi Metallo-β-Lactamase 14–producing Klebsiella pneumoniae sequence Type 147 clone in Spain and outbreak in the Canary Islands

Abstract

[Abstract] The emergence of a high-risk New Delhi metallo-β-lactamase 14–producing Klebsiella pneumoniae sequence type 147 clone is of public health concern because of its rapid international spread. We report cross-border emergence and rapid dissemination of that clone in the Canary Islands, Spain, during 2023–2025. We analyzed 30 isolates recovered during 2023 in detail by reviewing clinical and epidemiologic data, conducting whole-genome sequencing to assess clonal relatedness and analyze resistomes, and performing antimicrobial susceptibility testing of novel therapeutic options through reference broth microdilution. The isolates formed a well-defined cluster, with minimal genomic distance and identical resistomes, confirming the local outbreak. Those clones were also closely related to other international New Delhi metallo-β-lactamase 14–producing K. pneumoniae sequence type 147 isolates, supporting the ongoing cross-border expansion of that clone. Aztreonam/avibactam was the most active therapeutic option (MICs <0.125 mg/L). Our findings highlight the need for close monitoring to prevent further dissemination of this clone.