Emerging Microbes & Infections最新文献

{"title":"Genomic characterizations of <i>Klebsiella variicola:</i> emerging pathogens identified from sepsis patients in Ethiopian referral hospitals.","authors":"Melese Hailu Legese, Daniel Asrat, Adane Mihret, Badrul Hasan, Abraham Aseffa, Göte Swedberg","doi":"10.1080/22221751.2024.2440494","DOIUrl":"10.1080/22221751.2024.2440494","url":null,"abstract":"<p><p>Healthcare in low- and middle-income countries is becoming problematic due to the emergence of multidrug-resistant bacteria causing serious morbidity and mortality. <i>Klebsiella variicola</i> carrying multiple antimicrobial resistance (AMR) genes were found significantly among sepsis patients in a study done between October 2019 and September 2020 at four Ethiopian hospitals located in the central (Tikur Anbessa and Yekatit 12), southern (Hawassa), and northern (Dessie) parts. Among 1416 sepsis patients, 74 <i>K. variicola</i> isolates were identified using MALDI-TOF, most of them at Dessie (<i>n</i> = 44) and Hawassa (<i>n</i> = 28) hospitals. Whole genome sequencing showed that <i>K. variicola</i> strains identified at Dessie Hospital displayed phylogenetic clonality, carried an IncM1 plasmid and the majority were ST3924. Many <i>K. variicola</i> identified at Hawassa Hospital were clonally clustered and the majority belonged to novel STs and carried IncFIB(K) and IncFII(K) plasmids concurrently. Fifty <i>K. variicola</i> carried ESBL genes while 2 isolates harboured AmpC. Other frequently found genes were <i>aac(3)-lla, bla</i>_CTX-M-15, <i>bla</i>_TEM-1B, <i>bla</i>_LEN2, <i>bla</i>_OXA-1, <i>bla</i>_SCO-1, <i>catB3</i>, <i>dfrA14</i>, <i>QnrB1</i>, <i>aac(6')-lb-cr</i> and <i>sul2</i>. Virulence genes detected at both sites were <i>mrk operons</i> for biofilm formation and siderophore ABC transporter operons for iron uptake. Capsular alleles varied, with <i>wzi 269</i> at Dessie and <i>wzi 582</i> at Hawassa. The isolation of multidrug-resistant <i>K. variicola</i> as an emerging sepsis pathogen calls for strong infection prevention strategies and antimicrobial stewardship supported by advanced bacterial identification techniques.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2440494"},"PeriodicalIF":8.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isoniazid potentiates tigecycline to kill methicillin-resistant <i>Staphylococcus aureus</i>.","authors":"Xuan-Wei Chen, Hao-Qing Chen, Jia-Han Wu, Zhi-Han Wang, Yu-Qing Zhou, Si-Qi Tian, Bo Peng","doi":"10.1080/22221751.2024.2434587","DOIUrl":"10.1080/22221751.2024.2434587","url":null,"abstract":"<p><p>Therapeutic option for treating methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) infection is urgently required since its resistance to a broad spectrum of currently available antibiotics. Here, we report that isoniazid is able to potentiate the killing efficacy of tigecycline to MRSA. The combination of isoniazid and tigecycline reduces the minimal inhibitory concentration of clinic MRSA strains to tigecycline. The killing activity of tigecycline is further confirmed by killing experiments and murine infection model. We further demonstrate the mechanism that isoniazid increases intracellular accumulation of tigecycline by promoting the influx but limiting the efflux of tigecycline through proton motive force. We also show that isoniazid and tigecycline synergize to increase the abundance of isoniazid-NAD adduct, which in turn damage cell membrane, possibly contributing to the disruption of PMF. Whereas phosphatidylethanolamine and cardiolipin are able to abrogate the synergistic effect of isoniazid plus tigecycline. Thus our study provides a new perspective that antibiotics, e.g. isoniazid, once recognized only to target <i>Mycobacterium tuberculosis</i>, can be repurposed as antibiotic adjuvant to tigecycline, expanding our choice of antibiotic-antibiotic combinations in treating bacterial infectious diseases.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2434587"},"PeriodicalIF":8.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CoronaVac-induced antibodies that facilitate Fc-mediated neutrophil phagocytosis track with COVID-19 disease resolution.","authors":"Chuang Li, Jie Yu, Rahma Issa, Lili Wang, Mingzhe Ning, Shengxia Yin, Jie Li, Chao Wu, Yuxin Chen","doi":"10.1080/22221751.2024.2434567","DOIUrl":"10.1080/22221751.2024.2434567","url":null,"abstract":"<p><p>Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants raise concerns about decreased vaccine efficacy, vaccines continue to confer robust protection in humans, implying that immunity beyond neutralization contributes to vaccine efficacy. In addition to neutralization, antibodies can mediate various Fc-dependent effector functions, including antibody-dependent cellular phagocytosis (ADCP), antibody-dependent neutrophil phagocytosis (ADNP) and antibody-dependent cellular cytotoxicity (ADCC). However, the specific role of each Fc-mediated effector function in contributing to COVID-19 disease attenuation in human remains unclear. To fully define the potential immune correlates of Fc-mediated effector functions, we comprehensively analysed the above Fc-mediated effector functions in two study cohorts. In the CoronaVac vaccinee cohort, individuals without breakthrough infection exhibited higher levels of ADCP and ADNP activities with a greater degree of cross-reactivity compared to those who had breakthrough infection. A predictive model was established incorporating ADNP activity and IgG titre, achieving an area under the curve (AUC) of 0.837. In the COVID-19 patient cohort, BA.5-specific ADCP and ADNP responses were significantly reduced in COVID-19 patients with fatal outcomes compared to milder outcomes. The prognostic model incorporating WT, BA.5, and XBB.1.5 spike-specific ADNP demonstrated effective predictive ability, achieving an AUC of 0.890. Meanwhile, transcriptomic analysis of peripheral blood mononuclear cells (PBMCs) from COVID-19 patients in the acute phases of infection highlighted remarkably upregulation of neutrophil activity and phagocytic function, further reinforcing the essential role of ADNP. Collectively, our findings underscored Fc-mediated effector activities, especially neutrophil phagocytosis, as significant antibody biomarkers for the risk of SARS-CoV-2 breakthrough infection and COVID-19 prognosis.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2434567"},"PeriodicalIF":8.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A single mutation at position 214 of influenza B hemagglutinin enhances cross-neutralization.","authors":"Ziqi Cheng, Yeqing Sun, Yanru Shen, Xi Wu, Ling Pan, Hao Wu, Yunbo Bai, Chenyan Zhao, Junfeng Ma, Weijin Huang","doi":"10.1080/22221751.2025.2467770","DOIUrl":"10.1080/22221751.2025.2467770","url":null,"abstract":"<p><p>High variability of influenza B virus (IBV) hemagglutinin (HA) impairs the cross- neutralization ability of vaccines, leading to reduce efficacy. We identified significant differences in cross-neutralization between IBV strains B/Wyoming/06/2014 and B/Brisbane/60/2008, which differ in only three amino acid residues. The 214 T point mutation was found to dramatically enhance cross-neutralization (>10-fold). Antibody-based reverse validation also revealed that this mutation significantly increased the neutralization capacity (500-62,500-fold). Furthermore, monitoring revealed that the mutation rate at this site has reached its highest level in nearly 20 years, with a prevalence exceeding 80% in sequences submitted from certain regions. Our findings provide new evidence for the selection of vaccine strains with improved cross- neutralization effects, which will aid the development of broad-spectrum vaccines by modifying minimal antigenic epitopes.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2467770"},"PeriodicalIF":8.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rational mpox vaccine design: immunogenicity and protective effect of individual and multicomponent proteins in mice.","authors":"Xueting Cheng, Yawei Wang, Baoying Huang, Jialuo Bing, Tangqi Wang, Ruiwen Han, Shuting Huo, Shucai Sun, Li Zhao, Chang Shu, Yao Deng, Wenjie Tan","doi":"10.1080/22221751.2025.2482702","DOIUrl":"10.1080/22221751.2025.2482702","url":null,"abstract":"<p><p>The 2022 global mpox virus (MPXV) outbreak highlights the urgent need for safer, next-generation vaccines. We compared the immunogenicity and protective efficacy of individual and multicomponent membrane proteins of MPXV virions in mice to inform the development of a recombinant subunit vaccine against mpox. BALB/c mice were immunized with eukaryotically expressed A35R, A29L, B6R, and M1R proteins, administered individually or in multicomponent combinations with an Al(OH)₃ + CpG oligodeoxynucleotide adjuvant. Three multicomponent protein vaccines (A29/B6, A29/B6/M1, and A29/B6/M1/A35) provided complete protection, but others (individual protein and A35/M1 combinations) provided partial protection against challenge with high-lethal doses of vaccinia virus Western Reserve (VACV-WR). Additionally, A29/B6 conferred partial protection, whereas A29/B6/M1 and A29/B6/M1/A35 provided complete protection against ectromelia virus (ECTV), with A29/B6/M1 being most effective. All vaccines induced strong antigen-specific immunoglobulin G (IgG) and cellular immunity, whereas only four (M1, A35/M1, A29/B6/M1, A29/B6/M1/A35) exhibited significant neutralizing activity against MPXV, VACV-Tiantan, and ECTV. Correlation analysis suggested that neutralizing antibodies and A35-/A29-/B6-specific cellular immunity act as complementary defense mechanisms, potentially providing first- and second-line protection against MPXV and related orthopoxviruses. Collectively, A29/B6/M1 demonstrated the best protective efficacy. This study provides novel insights into immunogen optimization and potential mechanisms for the development of vaccines against MPXV and other orthopoxviruses.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2482702"},"PeriodicalIF":8.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial resistance in hypermucoviscous and non-hypermucoviscous <i>Klebsiella pneumoniae</i>: a systematic review and meta-analysis.","authors":"Hiroki Namikawa, Ken-Ichi Oinuma, Yukihiro Kaneko, Hiroshi Kakeya, Taichi Shuto","doi":"10.1080/22221751.2024.2438657","DOIUrl":"10.1080/22221751.2024.2438657","url":null,"abstract":"<p><p>Antimicrobial resistance has recently increased due to emerging carbapenem-resistant <i>Klebsiella pneumoniae</i> and extended-spectrum β-lactamase (ESBL)-producing strains of <i>K. pneumoniae</i>, especially among hypermucoviscous <i>K. pneumoniae</i> (hmKp) strains. To evaluate the prevalence of ESBL-producing and carbapenem-resistant strains in hmKp and non-hmKp clinical isolates through a systematic review and meta-analysis. We searched PubMed, Scopus, and Cochrane Library databases from January 2000 to June 2023. Clinical and in vivo/in vitro studies involving confirmed <i>K. pneumoniae</i> clinical isolates differentiated into hmKP and non-hmKP strains based on string test results. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated based on the number of individuals in each target group. Forest plots were used to visualize the effect sizes and 95% CIs of individual studies estimated using the inverse variance and DerSimonian - Laird methods with fixed - and random-effects models, respectively. Heterogeneity was assessed using Cochran's Q test (<i>I²</i> ≥ 50%). Fifteen studies comprising 2049 clinical isolates of <i>K. pneumoniae</i> met the inclusion criteria. Meta-analysis revealed that hmKp strains were associated with a significantly lower prevalence of ESBL-producing strains (pooled OR: 0.26, 95% CI: 0.11-0.63, <i>P</i> = 0.003) and a slightly lower prevalence of carbapenem-resistant strains than non-hmKp strains (pooled OR: 0.63, 95% CI: 0.40-0.97, <i>P</i> = 0.038). hmKp strains exhibited lower and slightly lower prevalence of ESBL production and carbapenem resistance, respectively, than non-hmKp strains. However, given the rising prevalence of ESBL-producing and carbapenem-resistant hmKp strains, patients infected by string-test-positive <i>K. pneumoniae</i> must be managed prudently, considering the potential for highly resistant strains.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2438657"},"PeriodicalIF":8.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The westward spread dynamics of cholera from the eastern endemic Democratic Republic of the Congo.","authors":"Harry César Ntumba Kayembe, Nadège Makuntima Taty, Hippolyte Nani-Tuma Situakibanza","doi":"10.1080/22221751.2024.2437245","DOIUrl":"10.1080/22221751.2024.2437245","url":null,"abstract":"","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2437245"},"PeriodicalIF":8.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term impact of molecular epidemiology shifts of methicillin-resistant <i>Staphylococcus aureus</i> on severity and mortality of bloodstream infection.","authors":"Norihito Kaku, Masaki Ishige, Go Yasutake, Daisuke Sasaki, Kenji Ota, Fujiko Mitsumoto-Kaseida, Kosuke Kosai, Hiroo Hasegawa, Koichi Izumikawa, Hiroshi Mukae, Katsunori Yanagihara","doi":"10.1080/22221751.2024.2449085","DOIUrl":"10.1080/22221751.2024.2449085","url":null,"abstract":"<p><p>A 2019 nationwide study in Japan revealed the predominant methicillin-resistant Staphylococcus aureus (MRSA) types in bloodstream infections (BSIs) to be sequence type (ST)8-carrying SCC<i>mec</i> type IV (ST8-MRSA-IV) and clonal complex 1-carrying SCC<i>mec</i> type IV (CC1-MRSA-IV). However, detailed patient characteristics and how these MRSA types evolve over time remain largely unknown. In this long-term single-center study, MRSA strains isolated from blood cultures at Nagasaki University Hospital from 2012 to 2019 were sequenced and analyzed. Additionally, we compared the SCC<i>mec</i> types and patient characteristics identified in this study with previous data from our hospital spanning 2003-2007 and 2008-2011. Over this 16-year period, SCC<i>mec</i> type II decreased significantly from 79.2% to 15.5%, while type IV increased from 18.2% to 65.5%. This shift in SCC<i>mec</i> types was associated with notable changes in severity and outcomes; the sequential organ failure assessment (SOFA) score decreased from 5.8 to 3.1; in-hospital mortality declined from 39.8% to 15.5%. In contrast, no significant changes in patient demographics, such as age, sex, or underlying diseases, were observed. Between 2012 and 2019, the major combinations of SCC<i>mec</i> type and sequence type were ST8-MRSA-IV, ST8-MRSA-I, CC1-MRSA-IV, and ST5-MRSA-II. Additionally, ST8-MRSA-IV was divided into CA-MRSA/J, t5071-ST8-MRSA-IV, and USA300-like clone based on the results of molecular analysis. These major combinations showed similar drug resistance patterns, molecular characteristics, and phylogenetic features to those identified in nationwide surveillance. This study highlights the evolving nature of MRSA types in bloodstream infections, correlating with improved patient outcomes over time.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":"14 1","pages":"2449085"},"PeriodicalIF":8.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid surge of reassortant A(H1N1) influenza viruses in Danish swine and their zoonotic potential.","authors":"Pia Ryt-Hansen, Sophie George, Charlotte Kristiane Hjulsager, Ramona Trebbien, Jesper Schak Krog, Marta Maria Ciucani, Sine Nygaard Langerhuus, Jennifer DeBeauchamp, Jeri Carol Crumpton, Taylor Hibler, Richard J Webby, Lars Erik Larsen","doi":"10.1080/22221751.2025.2466686","DOIUrl":"10.1080/22221751.2025.2466686","url":null,"abstract":"<p><p>In 2018, a single detection of a novel reassortant swine influenza A virus (swIAV) was made in Denmark. The hemagglutinin (HA) of the virus was from the H1N1 pandemic 2009 (H1N1pdm09) lineage and the neuraminidase (NA) from the H1N1 Eurasian avian-like swine lineage (H1N1av). By 2022, the novel reassortant virus (H1pdm09N1av) constituted 27% of swIAVs identified through the Danish passive swIAV surveillance program. Sequencing detected two H1pdm09N1av genotypes; Genotype 1 contained an entire internal gene cassette of H1N1pdm09 origin, Genotype 2 differed by carrying an NS gene segment of H1N1av origin. The internal gene cassette of Genotype 2 became increasingly dominant, not only in the H1pdm09N1av population, but also in other Danish enzootic swIAV subtypes. Phylogenetic analysis of the HA genes from H1pdm09N1av viruses revealed a monophyletic source, a higher substitution rate compared to other H1N1pdm09 viruses and genetic differences with human seasonal and other swine adapted H1N1pdm09 viruses. Correspondingly, H1pdm09N1av viruses were antigenically distinct from human H1N1pdm09 vaccine viruses. Both H1pdm09N1av genotypes transmitted between ferrets by direct contact, but only Genotype 1 was capable of efficient aerosol transmission. The rapid spread of H1pdm09N1av viruses in Danish swine herds is concerning for swine and human health. Their zoonotic threat is highlighted by the limited pre-existing immunity observed in the human population, aerosol transmission in ferrets and the finding that the internal gene cassette of Genotype 2 was present in the first two zoonotic influenza infections ever detected in Denmark.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2466686"},"PeriodicalIF":8.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The emergence of highly resistant and hypervirulent <i>Escherichia coli</i> ST405 clone in a tertiary hospital over 8 years.","authors":"Min Wang, Zhijun Zhang, Zhifei Sun, Xinying Wang, Jie Zhu, Meijie Jiang, Shuping Zhao, Liang Chen, Qiang Feng, Hong Du","doi":"10.1080/22221751.2025.2479048","DOIUrl":"10.1080/22221751.2025.2479048","url":null,"abstract":"<p><p>The emergence of carbapenem-resistant <i>Escherichia coli</i> (CREC) poses crucial challenges in clinical management, requiring continuous monitoring to inform control and treatment strategies. This study aimed to investigate the genomic and epidemiological characteristics of CREC isolates obtained from a tertiary hospital in China between 2015 and 2022. Next-generation sequencing was used for genomic profiling, and clinical data from patients were integrated into the analysis. ST405 (21.2%), ST167 (20.3%) and ST410 (15.9%) were the most prevalent of the 30 distinct sequence types (STs) identified among the 113 unique CREC isolates. Infections caused by the ST405 CREC clone and severe underlying diseases were associated with higher in-hospital mortality rates, particularly in patients aged ≥65 years. Furthermore, the ST405 clone exhibited a greater number of virulence and resistance genes than non-ST405 CREC clones. The virulence gene <i>eaeX</i> and resistance genes <i>mph(E)</i> and <i>msr(E)</i> were exclusively found in ST405 clones, while other virulence genes (<i>agn43</i>, <i>ipad</i> and <i>malX</i>) and resistance genes (<i>armA</i>, <i>catB3</i> and <i>arr-3</i>) were more prevalent in this clones. Additionally, ST405 showed higher minimum inhibitory concentrations for both meropenem and imipenem and showed superior growth under the meropenem challenge. <i>Galleria mellonella</i> virulence assays revealed that the ST405 CREC clone was more virulent than other predominant CREC STs. Our findings underscore the clinical threat posed by the ST405 CREC clone, which exhibits both enhanced virulence and extensive drug resistance. These results highlight the urgent need for stringent surveillance and targeted interventions to curb its further dissemination and prevent potential outbreaks.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2479048"},"PeriodicalIF":8.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}