{"title":"中国临床亚胺培南非敏感肺炎克雷伯菌分离株：流行病学、分子特征及亚胺培南/瑞巴坦体外活性","authors":"Peiyao Jia, Pengcheng Li, Wei Yu, Xiaobing Chu, Hui Zhang, Jingjia Zhang, Wei Kang, Ge Zhang, Qian Zhang, Shiyu Chen, Yingchun Xu, Qiwen Yang","doi":"10.1016/j.jgar.2025.05.011","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To describe the epidemiological and molecular characterization and in vitro activity of imipenem/relebactam against imipenem non-susceptible (IPMNS) Klebsiella pneumoniae isolates in China.</p><p><strong>Methods: </strong>K. pneumoniae isolates were collected from 16 sites in 5 regions across China during 2019. Antimicrobial susceptibility testing was performed. For IPMNS K. pneumoniae isolates, whole genome sequencing was used to screen for drug-resistance and virulence genes.</p><p><strong>Results: </strong>Of 1,011 clinical K. pneumoniae isolates, 277 (27.3%) were IPMNS and were significantly more common in ICU patients (47.5%) and hospital acquired infections (28.9%). Production of carbapenemase was the dominant resistance mechanism, with 228 (89.8%) IPMNS isolates harboring bla<sub>KPC-2</sub>, 8 (3.1%) bla<sub>NDM</sub>, 2 (0.7%) bla<sub>OXA-232</sub> and 1 (0.4%) bla<sub>OXA-181</sub>. The dominant clone was sequence type (ST) 11 (78.7%) followed by ST15 (10.2%). Relebactam restored imipenem's susceptibility in 96.3% isolates harboring a bla<sub>KPC-2</sub> gene.</p><p><strong>Conclusions: </strong>Harboring the bla<sub>KPC-2</sub> gene was the dominant mechanism of IPMNS K. pneumoniae in China. Empirical imipenem/relebactam treatment could be considered when susceptibility or carbapenemase tests are not available.</p>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical imipenem non-susceptible Klebsiella pneumoniae isolates from China: epidemiology, molecular characterization and in vitro activity of imipenem/relebactam.\",\"authors\":\"Peiyao Jia, Pengcheng Li, Wei Yu, Xiaobing Chu, Hui Zhang, Jingjia Zhang, Wei Kang, Ge Zhang, Qian Zhang, Shiyu Chen, Yingchun Xu, Qiwen Yang\",\"doi\":\"10.1016/j.jgar.2025.05.011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To describe the epidemiological and molecular characterization and in vitro activity of imipenem/relebactam against imipenem non-susceptible (IPMNS) Klebsiella pneumoniae isolates in China.</p><p><strong>Methods: </strong>K. pneumoniae isolates were collected from 16 sites in 5 regions across China during 2019. Antimicrobial susceptibility testing was performed. For IPMNS K. pneumoniae isolates, whole genome sequencing was used to screen for drug-resistance and virulence genes.</p><p><strong>Results: </strong>Of 1,011 clinical K. pneumoniae isolates, 277 (27.3%) were IPMNS and were significantly more common in ICU patients (47.5%) and hospital acquired infections (28.9%). Production of carbapenemase was the dominant resistance mechanism, with 228 (89.8%) IPMNS isolates harboring bla<sub>KPC-2</sub>, 8 (3.1%) bla<sub>NDM</sub>, 2 (0.7%) bla<sub>OXA-232</sub> and 1 (0.4%) bla<sub>OXA-181</sub>. The dominant clone was sequence type (ST) 11 (78.7%) followed by ST15 (10.2%). Relebactam restored imipenem's susceptibility in 96.3% isolates harboring a bla<sub>KPC-2</sub> gene.</p><p><strong>Conclusions: </strong>Harboring the bla<sub>KPC-2</sub> gene was the dominant mechanism of IPMNS K. pneumoniae in China. Empirical imipenem/relebactam treatment could be considered when susceptibility or carbapenemase tests are not available.</p>\",\"PeriodicalId\":15936,\"journal\":{\"name\":\"Journal of global antimicrobial resistance\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-05-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of global antimicrobial resistance\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jgar.2025.05.011\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of global antimicrobial resistance","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jgar.2025.05.011","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Clinical imipenem non-susceptible Klebsiella pneumoniae isolates from China: epidemiology, molecular characterization and in vitro activity of imipenem/relebactam.
Objectives: To describe the epidemiological and molecular characterization and in vitro activity of imipenem/relebactam against imipenem non-susceptible (IPMNS) Klebsiella pneumoniae isolates in China.
Methods: K. pneumoniae isolates were collected from 16 sites in 5 regions across China during 2019. Antimicrobial susceptibility testing was performed. For IPMNS K. pneumoniae isolates, whole genome sequencing was used to screen for drug-resistance and virulence genes.
Results: Of 1,011 clinical K. pneumoniae isolates, 277 (27.3%) were IPMNS and were significantly more common in ICU patients (47.5%) and hospital acquired infections (28.9%). Production of carbapenemase was the dominant resistance mechanism, with 228 (89.8%) IPMNS isolates harboring blaKPC-2, 8 (3.1%) blaNDM, 2 (0.7%) blaOXA-232 and 1 (0.4%) blaOXA-181. The dominant clone was sequence type (ST) 11 (78.7%) followed by ST15 (10.2%). Relebactam restored imipenem's susceptibility in 96.3% isolates harboring a blaKPC-2 gene.
Conclusions: Harboring the blaKPC-2 gene was the dominant mechanism of IPMNS K. pneumoniae in China. Empirical imipenem/relebactam treatment could be considered when susceptibility or carbapenemase tests are not available.
期刊介绍：
The Journal of Global Antimicrobial Resistance (JGAR) is a quarterly online journal run by an international Editorial Board that focuses on the global spread of antibiotic-resistant microbes.
JGAR is a dedicated journal for all professionals working in research, health care, the environment and animal infection control, aiming to track the resistance threat worldwide and provides a single voice devoted to antimicrobial resistance (AMR).
Featuring peer-reviewed and up to date research articles, reviews, short notes and hot topics JGAR covers the key topics related to antibacterial, antiviral, antifungal and antiparasitic resistance.
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