Emergence and molecular evolution of carbapenem-resistant hypervirulent ST23 Klebsiella pneumoniae: The superbug phenomenon in China.

IF 5.4 1区农林科学 Q1 IMMUNOLOGY

Virulence Pub Date : 2025-12-01 Epub Date: 2025-08-13 DOI:10.1080/21505594.2025.2545556

Tao Chen, Xueting Wang, Luying Xiong, Ping Shen, Yonghong Xiao

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引用次数: 0

Abstract

This study aimed to investigate the molecular epidemiology of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) ST23 in China. We conducted comprehensive searches across five databases (PubMed, Web of Science, MEDLINE, CNKI, and Wanfang) spanning 1980-2024, identifying 30 eligible studies through rigorous screening. Our synthesis documents 120 ST23 CR-hvKP clinical isolates, including the earliest known case from Zhejiang in 2013 which harbored bla_KPC-2 alongside hallmark virulence loci (rmpA, rmpA2, iroN, iucA, and pagO). Epidemiological analysis of 119 isolates reveals geographic disparities: Hebei (25.2%) and Jiangxi (22.7%) are hotspots, while carbapenemase distribution exhibits a north-south divide (bla_NDM predominating in northern China versus bla_KPC in the south). Phylogenetic analysis of 584 global ST23 genomes suggests independent plasmid-mediated acquisition of carbapenemase genes, with evidence of clonal transmission both among humans and between humans and environmental niches. This review highlights the urgent need for surveillance to track CR-hvKP's evolving epidemiology, alongside interventions targeting plasmid-driven resistance spread.

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耐碳青霉烯高毒力ST23肺炎克雷伯菌的出现与分子进化：中国的超级细菌现象。

本研究旨在了解耐碳青霉烯高致病性肺炎克雷伯菌ST23在中国的分子流行病学。我们对五个数据库（PubMed, Web of Science， MEDLINE， CNKI和万方）进行了全面的检索，时间跨度为1980-2024年，通过严格的筛选，确定了30项符合条件的研究。我们合成了120株ST23 CR-hvKP临床分离株，包括2013年浙江最早的已知病例，该病例携带blaKPC-2以及标志性毒力位点（rmpA, rmpA2, iroN， iucA和pagO）。119株分离株的流行病学分析显示地域差异：河北（25.2%）和江西（22.7%）是碳青霉烯酶的热点地区，而碳青霉烯酶的分布呈现南北差异（北方以blaNDM为主，南方以blaKPC为主）。对全球584个ST23基因组的系统发育分析表明，碳青霉烯酶基因是独立的质粒介导获得的，在人与人之间以及人与环境生态位之间都有克隆传播的证据。这一综述强调了迫切需要监测以跟踪CR-hvKP不断演变的流行病学，以及针对质粒驱动的耐药性传播的干预措施。

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

Virulence IMMUNOLOGY-MICROBIOLOGY

CiteScore

9.20

自引率

1.90%

发文量

123

审稿时长

6-12 weeks

期刊介绍： Virulence is a fully open access peer-reviewed journal. All articles will (if accepted) be available for anyone to read anywhere, at any time immediately on publication. Virulence is the first international peer-reviewed journal of its kind to focus exclusively on microbial pathogenicity, the infection process and host-pathogen interactions. To address the new infectious challenges, emerging infectious agents and antimicrobial resistance, there is a clear need for interdisciplinary research.