Venn diagram of blaKPC-containing plasmids detected in the environment and patients. Venn diagram of blaKPC-containing plasmids detected in the environment and patients. The presence of plasmids in isolates from patients and/or the environment was based on a k-mer inclusion approach for which a plasmid was considered present within a genome assembly if ≥95% of the plasmid k-mers were contained within the MiSeq genome assembly k-mers. Each value is the number of isolates detected in this study that carry the specified blaKPC-containing plasmid. In the overlapping region, the ratio indicates the number of environmental isolates/number of patient isolates. Plasmids are drawn to scale. The inner circle represents the blaKPC allele, and the outer circle represents the transposon. The blaKPC alleles are blue for blaKPC2 and pink for blaKPC3. Color was used to differentiate the flanking sequence as follows: orange, Tn4401a; purple, Tn4401b; red, Tn4401b-IS630; gray, Tn4401d; green, IS26-TnpA; light blue, Ahyd_WCHAH01; black, not determined. Rebecca A. Weingarten et al. mBio 2018; doi:10.1128/mBio.02011-17