Clinical imipenem non-susceptible Klebsiella pneumoniae isolates from China: Epidemiology, molecular characterization and in vitro activity of imipenem/relebactam

作者：Peiyao Jia, Pengcheng Li, Wei Yu, Xiaobing Chu, Hui Zhang, Jingjia Zhang, Wei Kang, Ge Zhang, Qian Zhang, Shiyu Chen, Yingchun Xu, Qiwen Yang · 发表于：Journal of Global Antimicrobial Resistance · 年份：2025 · DOI：10.1016/j.jgar.2025.05.011 · 被引用次数：2 · 研究领域：Antibiotic Resistance in Bacteria、Antibiotic Use and Resistance、Antibiotics Pharmacokinetics and Efficacy

ABSTRACT 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 bla KPC-2 , 8 (3.1%) bla NDM , 2 (0.7%) bla OXA-232 and 1 (0.4%) bla OXA-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 bla KPC-2 gene. Conclusions : Harboring the bla KPC-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.