Genomic epidemiology study of Klebsiella pneumoniae causing bloodstream infections in China

作者：Xinmiao Jia, Cuidan Li, Fei Chen, Xue Li, Peiyao Jia, Ying Zhu, Tianshu Sun, Fupin Hu, Xiaofeng Jiang, Yunsong Yu, Bijie Hu, Qing Yang, Qing Yang, Mei Kang, Hongjie Liang, Kang Liao, Longhua Hu, Li Gu, Yan Jin, Qiong Duan, Shufang Zhang, Ziyong Sun, Wenxiang Huang, Hong He, Haifeng Shao, Bin Shan, Chao Zhuo, Ping Ji, Rui Zheng, Gang Li, Yingchun Xu, Qiwen Yang, Qiwen Yang · 发表于：Clinical and Translational Medicine · 年份：2021 · DOI：10.1002/ctm2.624 · 被引用次数：25 · 研究领域：Antibiotic Resistance in Bacteria、Mycobacterium research and diagnosis、Tuberculosis Research and Epidemiology

Klebsiella pneumoniae (K. pneumoniae, Kpn) bloodstream infection (BSI) has a considerable prevalence and high mortality worldwide.1-3 The emergence of carbapenem-resistant BSI-Kpns, especially those with hypervirulence, poses a challenge for BSI-Kpn control worldwide.4-6 We conducted a large-scale multicenter epidemiological study and in-depth genomic analysis of BSI-Kpns in China, describing a complete molecular epidemiological picture (clinical features, sequence types (STs)/serotypes, antimicrobial resistance/hypervirulence, phenotype/genotype) of BSI-Kpns. We also revealed the correlations between clinical characteristics and the genotypes of BSI-Kpns. A total of 239 Kpns were identified by screening 1219 Gram-negative bacteria causing BSI from 24 representative hospitals in different regions of China in 2018 (Table 1 and Figure 1; Table S1 and Figure S1). A total of 67.36% (161/239) infections were hospital-onset (HO), and the others were community-onset (CO). A total of 66.11% (158/239) patients were males, and middle-aged (41–65 years, 118/239, 49.37%) and aged (>65 years, 81/239, 33.89%) patients accounted for a significantly higher percentage (p-value < 0.0001) (Table 1; Table S2). We further sequenced the whole genomes of 239 BSI-Kpns using Illumina Technology (Tables S3 and S4). ST analysis indicated that these strains covered 78 different STs, including seven new STs (Table S5). The most common STs were ST11, ST23 and ST65, together accounting for 41% (98/239) of ...