Genomic characteristics and phylogenetic analyses of colonization and infection with carbapenem-resistant Klebsiella pneumoniae in multicenter intensive care units: a cohort study

作者：Yile Wu, Wen-Wen Chu, Xiaoqian Hu, Yi-Yu Lyu, Jie-Hao Tai, Ruo-Jie Li, Kai Huang, Xue Zhao, Wenhui Zhang, Xue‐Ping Wang, Xiang Yan, Zhou Liu, Xiyao Yang, Qiang Zhou, Min Yang · 发表于：Microbiology Spectrum · 年份：2025 · DOI：10.1128/spectrum.01584-24 · 被引用次数：7 · 研究领域：Antibiotic Resistance in Bacteria、Antibiotics Pharmacokinetics and Efficacy、Antibiotic Use and Resistance

ABSTRACT Carbapenem-resistant Klebsiella pneumoniae ( CRKp ) poses a major threat to global public health. This study aimed to investigate the genomic characteristics and phylogenetic relatedness of colonization and infection with CRKp among intensive care unit (ICU) patients. A total of 61 CRKp isolates, including 29 non-ICU-acquired and 32 ICU-acquired strains, were collected by active screening and infection culture from 16 ICUs through a multicenter cohort study. Following whole-genome sequencing (WGS), seven sequence types (STs) were identified, with ST11 (60.7%) being the most dominant, followed by ST15 (27.9%). Most strains (93.4%) carried the bla KPC-2 gene, while 9.8% and 3.3% of strains carried either the bla NDM-1 gene or both genes. A high abundance of virulence genes including iutA (55.7%), rmpA (18.0%), and rmpA2 (52.5%) were identified, with iutA +rmpA2 (37.7%) being the most common combination. The IncHI1B plasmid was identified in all of the 34 strains carrying the detected virulence genes. Furthermore, results from cgMLST analysis revealed 10 clusters with highly homogeneous CRKp strains, from which the potential interregional and intrahospital spread of CRKp were hypothesized. Here, this study reveals the widespread distribution of CRKp as well as locally specific strains in different regions of Anhui Province. The observed high abundance of virulence genes requires additional attention and continued monitoring. Taken together, these findings highlight the ...