Novel Subclone of Carbapenem-Resistant Klebsiella pneumoniae Sequence Type 11 with Enhanced Virulence and Transmissibility, China

We aimed to clarify the epidemiologic and clinical importance of evolutionary events that occurred in carbapenem-resistant Klebsiella pneumoniae (CRKP). We collected 203 CRKP causing bloodstream infections in a tertiary hospital in China during 2013-2017. We detected a subclonal shift in the dominan...

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Vydáno v:Emerging infectious diseases Ročník 26; číslo 2; s. 289 - 297
Hlavní autoři: Zhou, Kai, Xiao, Tingting, David, Sophia, Wang, Qin, Zhou, Yanzi, Guo, Lihua, Aanensen, David, Holt, Kathryn E., Thomson, Nicholas R., Grundmann, Hajo, Shen, Ping, Xiao, Yonghong
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States U.S. National Center for Infectious Diseases 01.02.2020
Centers for Disease Control and Prevention
Témata:
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - pharmacology
Anti-Bacterial Agents - therapeutic use
Antibiotics
Antimicrobial agents
carbapenem resistance
Carbapenem-Resistant Enterobacteriaceae - drug effects
Carbapenem-Resistant Enterobacteriaceae - isolation & purification
China
China - epidemiology
Chinese history
Cloning
Diversification
Drug Resistance, Multiple, Bacterial
Female
Genomes
Health aspects
Humans
Imipenem
Infection
Infections
Klebsiella Infections - drug therapy
Klebsiella Infections - epidemiology
Klebsiella Infections - mortality
Klebsiella Infections - prevention & control
Klebsiella pneumoniae
Klebsiella pneumoniae - drug effects
Klebsiella pneumoniae - genetics
Klebsiella pneumoniae - isolation & purification
Klebsiella pneumoniae - pathogenicity
Male
Medical Records
Meropenem
Microbial Sensitivity Tests
Middle Aged
Mortality
Novel Subclone of Carbapenem-Resistant
Patients
Phylogenetics
Phylogeny
Pneumonia
Population
Prevalence
recombination
Retrospective Studies
Sequence Type 11 with Enhanced Virulence and Transmissibility, China
ST11
subclonal shift
Survival Analysis
Tigecycline
Virulence
Young Adult
China
Europe
subclonal shift
recombination
bacteria
carbapenem resistance
virulence
antimicrobial resistance
China
ST11
bacterial infections
Klebsiella pneumoniae
ISSN:1080-6040, 1080-6059, 1080-6059
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Shrnutí:We aimed to clarify the epidemiologic and clinical importance of evolutionary events that occurred in carbapenem-resistant Klebsiella pneumoniae (CRKP). We collected 203 CRKP causing bloodstream infections in a tertiary hospital in China during 2013-2017. We detected a subclonal shift in the dominant clone sequence type (ST) 11 CRKP in which the previously prevalent capsular loci (KL) 47 had been replaced by KL64 since 2016. Patients infected with ST11-KL64 CRKP had a significantly higher 30-day mortality rate than other CRKP-infected patients. Enhanced virulence was further evidenced by phenotypic tests. Phylogenetic reconstruction demonstrated that ST11-KL64 is derived from an ST11-KL47-like ancestor through recombination. We identified a pLVPK-like virulence plasmid carrying rmpA and peg-344 in ST11-KL64 exclusively from 2016 onward. The pLVPK-like-positive ST11-KL64 isolates exhibited enhanced environmental survival. Retrospective screening of a national collection identified ST11-KL64 in multiple regions. Targeted surveillance of this high-risk CRKP clone is urgently needed.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1080-6040
1080-6059
1080-6059
DOI:10.3201/eid2602.190594