Higher prevalence of hypervirulent Klebsiella pneumoniae isolates with high-risk multidrug resistance in Asia

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-05-23 DOI:10.1016/j.jiph.2025.102834

Lin Gan , Pan Mao , Ziyan Tian , Xin Li , Zihui Yu , Bing Du , Guanhua Xue , Chao Yan , Jinghua Cui , Hanqing Zhao , Yanling Feng , Junxia Feng , Zheng Fan , Tongtong Fu , Ziying Xu , Yang Yang , Lijuan Huang , Shuo Zhao , Jing Yuan

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引用次数: 0

Abstract

Background

The emergence of hypervirulent and antibiotic-resistant Klebsiella pneumoniae isolates poses a significant global public health threat, necessitating stringent prevention and control strategies on an international scale. However, current research efforts are often geographically restricted and lack integration of large-scale data analyses, limiting the understanding of the global prevalence and molecular epidemiology of K. pneumoniae. Furthermore, studies on hypervirulent K. pneumoniae (hvKp) have predominantly emphasized virulence traits, with limited exploration of their associations with molecular subtypes, such as sequence types (STs) and capsule types.

Methods

To address these gaps, a total of 55,684K. pneumoniae isolates collected across global regions, were applied in this study to investigate virulence factors, antimicrobial resistance profiles, molecular typing characteristics and the intrinsic connections between these features.

Results

Through the application of big data analytics, we generated a comprehensive global distribution map of K. pneumoniae, revealing a higher prevalence of hvKp isolates with high-risk multidrug resistance in Asia. Notably, sequence types ST23, ST65, and ST86 exhibited the highest proportions of hvKp isolates. Regional differences in the virulence potential of specific sequence types were associated with the presence of aerobactin, a key siderophore. Additionally, capsular type KL64 was identified as potentially correlated with hypervirulence.

Conclusions

This large-scale genomic surveillance offers critical insights into the global distribution and molecular epidemiology of K. pneumoniae, providing an evidence base for risk mapping and the formulation of tailored control strategies to mitigate the threat posed by this pathogen.

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高致病性肺炎克雷伯菌分离株在亚洲具有高风险多药耐药的较高患病率

高毒力和耐药肺炎克雷伯菌分离株的出现对全球公共卫生构成重大威胁，需要在国际范围内采取严格的预防和控制策略。然而，目前的研究工作往往受到地理限制，缺乏大规模数据分析的整合，限制了对肺炎克雷伯菌全球流行病学和分子流行病学的理解。此外，对高毒力肺炎克雷伯菌（hvKp）的研究主要强调毒力特征，而对其与分子亚型（如序列型（STs）和胶囊型）的关联的探索有限。方法解决这些差距，共55684k。本研究利用在全球各地收集的肺炎分离株，研究其毒力因子、耐药谱、分子分型特征以及这些特征之间的内在联系。结果通过应用大数据分析，我们绘制了肺炎克雷伯菌的综合全球分布图，揭示了hvKp分离株在亚洲的高流行率，具有高风险的多药耐药。值得注意的是，序列型ST23、ST65和ST86中hvKp的分离比例最高。特定序列类型的毒力潜力的区域差异与有氧肌动蛋白的存在有关，有氧肌动蛋白是一种关键的铁载体。此外，荚膜型KL64被确定为潜在的高毒力相关。结论大规模基因组监测为了解肺炎克雷伯菌的全球分布和分子流行病学提供了重要信息，为绘制肺炎克雷伯菌的风险图谱和制定有针对性的控制策略提供了证据基础。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.