TY - JOUR
T1 - Molecular epidemiology of carbapenem-resistant hypervirulent Klebsiella pneumoniae in China
AU - Yang, Xuemei
AU - Sun, Qiaoling
AU - Li, Jiaping
AU - Jiang, Yu
AU - Li, Yi
AU - Lin, Jianping
AU - Chen, Kaichao
AU - Chan, Edward Wai Chi
AU - Zhang, Rong
AU - Chen, Sheng
N1 - Funding Information:
This work was supported by Guangdong Major Project of Basic and Applied Basic Research [2020B0301030005] and the National Natural Science Foundation of China [No. 81861138052, 81772250, and 82102451]. XMY performed whole genome sequencing and bioinformatics analysis and drafted the manuscript; QLS and YL collected the strains, performed strain characterization and collected clinical data; JPL, YJ, JPJ and KCC helped with strain characterization and clinical data analysis; EWC helped with study design and manuscript writing; RZ and SC designed and supervised the study, and interpreted the data; SC wrote the manuscript.
Publisher Copyright:
© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022/3
Y1 - 2022/3
N2 - The epidemiological features of the newly emerged carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-HvKP) and its potential threat to human health are currently unknown. In this study, a total of 784 bla KPC-2-bearing CRKP strains collected from three hospitals located at different geographical locales in China during 2014–2017 were subjected to molecular typing, screening of virulence plasmid, string test and WGS (367/784 strains). The proportion of CRKP among all clinical K. pneumoniae strains increased sharply in China during 2014–2017. A large proportion (58%) of these CRKP strains were found to harbour a virulence-encoding plasmid, while only 13% of such strains exhibited a hypervirulent phenotype by string test and neutrophil assay. The lack of hypervirulent phenotype in virulent plasmid-bearing CRKP strains was found to be due to the mutation’s presence on rmpA and rmpA2 genes, which rendered them non-functional, while some strains carrying wild type rmpA did not exhibit hypervirulent phenotype either suggesting that other factors might also contribute to the hypervirulence of CRKP. Phylogenetic and SNP analysis indicated that the transmission of these CRKP strains in China likely involved several major clones of ST11. Carriage of IncFII pSWU01-like, bla KPC-2-bearing plasmid was found to be the major mechanism of carbapenem resistance in these CRKP strains. In conclusion, our data indicated that the prevalence of CRKP strains carrying the virulence plasmid has rapidly increased in China, while genetic markers were not correlated well with the hypervirulent phenotypes, which call for a better definition and screening for these truly hypervirulent CR-HvKP strains in clinical settings.
AB - The epidemiological features of the newly emerged carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-HvKP) and its potential threat to human health are currently unknown. In this study, a total of 784 bla KPC-2-bearing CRKP strains collected from three hospitals located at different geographical locales in China during 2014–2017 were subjected to molecular typing, screening of virulence plasmid, string test and WGS (367/784 strains). The proportion of CRKP among all clinical K. pneumoniae strains increased sharply in China during 2014–2017. A large proportion (58%) of these CRKP strains were found to harbour a virulence-encoding plasmid, while only 13% of such strains exhibited a hypervirulent phenotype by string test and neutrophil assay. The lack of hypervirulent phenotype in virulent plasmid-bearing CRKP strains was found to be due to the mutation’s presence on rmpA and rmpA2 genes, which rendered them non-functional, while some strains carrying wild type rmpA did not exhibit hypervirulent phenotype either suggesting that other factors might also contribute to the hypervirulence of CRKP. Phylogenetic and SNP analysis indicated that the transmission of these CRKP strains in China likely involved several major clones of ST11. Carriage of IncFII pSWU01-like, bla KPC-2-bearing plasmid was found to be the major mechanism of carbapenem resistance in these CRKP strains. In conclusion, our data indicated that the prevalence of CRKP strains carrying the virulence plasmid has rapidly increased in China, while genetic markers were not correlated well with the hypervirulent phenotypes, which call for a better definition and screening for these truly hypervirulent CR-HvKP strains in clinical settings.
KW - CR-HvKP
KW - epidemiology
KW - Klebsiella pneumoniae
KW - prevalence
KW - virulence plasmid
UR - http://www.scopus.com/inward/record.url?scp=85126823673&partnerID=8YFLogxK
U2 - 10.1080/22221751.2022.2049458
DO - 10.1080/22221751.2022.2049458
M3 - Journal article
C2 - 35236251
AN - SCOPUS:85126823673
SN - 2222-1751
VL - 11
SP - 841
EP - 849
JO - Emerging Microbes and Infections
JF - Emerging Microbes and Infections
IS - 1
ER -