Molecular and Clinical Characteristics of Carbapenem-Resistant Klebsiella pneumoniae Isolates at a Tertiary Hospital in Wuhan, China

Fan Hu,1,2,* Meng-Lu Lin,1,2,* Juan-Li Mou,1,2,* Jia-Hui Feng,1,2 Kai Huang,1,2 Yao-Jia Lao,1,2 Jie Cheng,1,2 Jun Lin1,2 1Department of Gastroenterology/Hepatology, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China; 2The Hubei Clinical Center & Key Laboratory of Intestinal & Colorectal Diseases, Wuhan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jun Lin, Email linjun64@126.comBackground: Carbapenem resistant Klebsiella pneumoniae (CRKP) is an independent risk factor for nosocomial infection which poses a serious threat to human health. How to prevent and suppress CRKP infection and explore its drug resistance mechanisms have become a huge challenge and possesses immediate significance.Methods: A total of 45 CRKP strains isolated from hospitalized patients in Zhongnan Hospital of Wuhan University were collected from August 2018-December 2020. The strain’s identification and antimicrobial susceptibility tests were performed using the VITEK 2 automated identification instrument. Single molecule DNA sequencing of 45 CRKP isolates was performed by the third generation high-throughput sequencing technology.Results: The results were analyzed by multi locus sequence typing (MLST) and phylogenetic analysis. Antimicrobial susceptibility showed that 45 CRKP isolates were multi-drug resistant strains, and the resistance rates to common antibiotics were as high as 68%. Whole genome sequencing results showed that the CRKP strains carried multiple drug resistance genes and virulence factors. MLST analysis found two different sequence types (ST), of which 44 were ST11 and 1 was ST1049.Conclusion: Through whole genome sequencing (WGS), we found multiple drug-resistant genes and virulence factors, and there was obvious dominant microbiota. The source was mainly related to nosocomial infection. The ST11-KPC Klebsiella pneumoniae was the main type, which was consistent with