Molecular and epidemiological characterization of carbapenem-resistant hypervirulent Klebsiella pneumoniae in Huaian, China (2022-2024): a retrospective study.

IF 4.8 2区医学 Q2 IMMUNOLOGY

Frontiers in Cellular and Infection Microbiology Pub Date : 2025-06-04 eCollection Date: 2025-01-01 DOI:10.3389/fcimb.2025.1569004

Jianchun Lian, Qianhui Li, Cheng Peng, Tao Lin, Hong Du, Chaogui Tang, Xiaoyun Zhang

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引用次数: 0

Abstract

Objectives: Carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) poses a significant public health challenge. This study investigated the molecular epidemiology, antimicrobial resistance patterns, clinical characteristics, and risk factors of CR-hvKP infection in Huaian, China.

Methods: We retrospectively studied patients infected with carbapenem-resistant K. pneumoniae (CRKP) between November 2022 and September 2024. Whole-genome sequencing was used to detect carbapenemase, virulence, capsular serotype-related genes, and plasmid types in 374 CRKP isolates.

Results: Among them, 57.49% (215/374) strains met the criteria for CR-hvKP. The most common type was blaKPC-2-producing ST11(98.60%, 212/215), whereas K64 (56.74%, 122/215) and KL25 (39.53%, 85/215) were the main capsular serotypes. The CR-hvKP strains showed significantly higher resistance to the tested antibiotics, except for ceftazidime/avibactam and colistin. Resistance rates of CR-hvKP to the three tested antibiotics (minocycline, cotrimoxazole, and amikacin) were higher than those of CRnon-hvKP. Phylogenetic analysis based on whole-genome single-nucleotide polymorphisms divided the 251 isolates into four independent branches, with branch 2 being the most prevalent, indicating high clonality among the strains. Multivariate analysis showed diabetes [odds ratio (OR) = 3.771] and surgery (OR =2.042) to be independent variables associated with CR-hvKP infection.

Conclusions: Notably, the ST11 lineage carrying blaKPC-2 has emerged as a dominant high-risk clone in Huaian. Given the wide distribution of these novel CR-hvKP isolates, global monitoring and stricter control measures should be implemented to prevent their further spread in hospital settings.

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淮安市2022-2024年耐碳青霉烯高毒肺炎克雷伯菌分子及流行病学特征的回顾性研究

目的：碳青霉烯耐药高致病性肺炎克雷伯菌（CR-hvKP）是一项重大的公共卫生挑战。本研究旨在了解淮安市CR-hvKP感染的分子流行病学、耐药模式、临床特征及危险因素。方法：回顾性研究2022年11月至2024年9月期间感染耐碳青霉烯类肺炎克雷伯菌（CRKP）的患者。采用全基因组测序技术检测374株CRKP分离株的碳青霉烯酶、毒力、荚膜血清型相关基因和质粒类型。结果：其中符合CR-hvKP标准的菌株占57.49%（215/374）。最常见的荚膜血清型为产blakpc -2的ST11型（98.60%,212/215），K64型（56.74%,122/215）和KL25型（39.53%,85/215）是主要的荚膜血清型。除了头孢他啶/阿维巴坦和粘菌素外，CR-hvKP菌株对所测抗生素的耐药率显著高于其他菌株。CR-hvKP对米诺环素、复方新诺明、阿米卡星3种抗生素的耐药率高于CRnon-hvKP。基于全基因组单核苷酸多态性的系统发育分析将251株分离株划分为4个独立分支，分支2最为普遍，表明菌株间具有较高的克隆性。多因素分析显示，糖尿病[比值比(OR) = 3.771]和手术（OR =2.042）是与CR-hvKP感染相关的独立变量。结论：值得注意的是，携带blaKPC-2的ST11谱系已成为淮安地区显性高风险克隆。鉴于这些新型CR-hvKP分离株分布广泛，应实施全球监测和更严格的控制措施，以防止其在医院环境中进一步传播。

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

Frontiers in Cellular and Infection Microbiology IMMUNOLOGY-MICROBIOLOGY

CiteScore

7.90

自引率

7.00%

发文量

1817

审稿时长

14 weeks

期刊介绍： Frontiers in Cellular and Infection Microbiology is a leading specialty journal, publishing rigorously peer-reviewed research across all pathogenic microorganisms and their interaction with their hosts. Chief Editor Yousef Abu Kwaik, University of Louisville is supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Cellular and Infection Microbiology includes research on bacteria, fungi, parasites, viruses, endosymbionts, prions and all microbial pathogens as well as the microbiota and its effect on health and disease in various hosts. The research approaches include molecular microbiology, cellular microbiology, gene regulation, proteomics, signal transduction, pathogenic evolution, genomics, structural biology, and virulence factors as well as model hosts. Areas of research to counteract infectious agents by the host include the host innate and adaptive immune responses as well as metabolic restrictions to various pathogenic microorganisms, vaccine design and development against various pathogenic microorganisms, and the mechanisms of antibiotic resistance and its countermeasures.