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Epidemiology of carbapenem-resistant Klebsiella pneumoniae in China and the evolving trends of predominant clone ST11: a multicentre, genome-based study.
- Source :
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The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2024 Sep 03; Vol. 79 (9), pp. 2292-2297. - Publication Year :
- 2024
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Abstract
- Objectives: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major nosocomial infectious pathogen with rapidly increasing prevalence. The genomic epidemiological characteristics of CRKP nationwide, especially the evolving trends within the predominant clones, should be evaluated clearly.<br />Methods: We collected 3415 K. pneumoniae strains from 28 hospitals across China. Antimicrobial susceptibility testing and WGS were performed. Subsequent genomic analyses, including sequence typing, K-locus (KL) identification, antimicrobial resistance gene screening, and virulence score assessment were performed. The phylogenetic relationship of clonal group 11 was determined based on core-genome analysis, and the presence of the pLVPK-like virulence plasmid in ST11 isolates was confirmed using plasmid core-gene analysis. Additionally, the trends of the ST11 lineage with different KL types on a global scale were investigated using Beast2.<br />Results: Of the K. pneumoniae strains, 708 were identified as CRKP isolates (20.7%), of which 97.7% were MDR. ST11 was the predominant clone, and KPC-2 was the prevalent carbapenemase in China, although the prevalence of specific clones and carbapenemases varied by geographic region. Among ST11 isolates, KL47 and KL64 were the predominant KL types, and KL64 gradually replaced KL47, with a higher percentage of KL64 isolates harbouring the pLVPK-like plasmid. Global genome data showed a significant increase in the effective population size of KL64 over the last 5 years.<br />Conclusions: The prevalence of CRKP was very high in certain regions in China. The increasing convergence of virulence and resistance, particularly in ST11-KL64 isolates, should be given more attention and further investigation.<br /> (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our siteāfor further information please contact journals.permissions@oup.com.)
- Subjects :
- China epidemiology
Humans
beta-Lactamases genetics
Genome, Bacterial
Carbapenems pharmacology
Bacterial Proteins genetics
Multilocus Sequence Typing
Virulence genetics
Cross Infection epidemiology
Cross Infection microbiology
Molecular Epidemiology
Prevalence
Drug Resistance, Multiple, Bacterial genetics
Klebsiella pneumoniae genetics
Klebsiella pneumoniae drug effects
Klebsiella pneumoniae isolation & purification
Klebsiella pneumoniae classification
Klebsiella Infections epidemiology
Klebsiella Infections microbiology
Microbial Sensitivity Tests
Whole Genome Sequencing
Plasmids genetics
Anti-Bacterial Agents pharmacology
Carbapenem-Resistant Enterobacteriaceae genetics
Carbapenem-Resistant Enterobacteriaceae drug effects
Carbapenem-Resistant Enterobacteriaceae isolation & purification
Phylogeny
Subjects
Details
- Language :
- English
- ISSN :
- 1460-2091
- Volume :
- 79
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- The Journal of antimicrobial chemotherapy
- Publication Type :
- Academic Journal
- Accession number :
- 38997220
- Full Text :
- https://doi.org/10.1093/jac/dkae227