Results
Title

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

Authors

Kai Zhou; Tingting Xiao; David, Sophia; Qin Wang; Yanzi Zhou; Lihua Guo; Aanensen, David; Holt, Kathryn E.; Thomson, Nicholas R.; Grundmann, Hajo; Ping Shen; Yonghong Xiao; Zhou, Kai; Xiao, Tingting; Wang, Qin; Zhou, Yanzi; Guo, Lihua; Shen, Ping; Xiao, Yonghong

Abstract

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shift in the dominant clone sequence type (ST) 11 CRKP in which the previously prevalent capsular loci (KL) 47 had been replaced by KL64 since 2016.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.

Subjects

CHINA; DRUG resistance in microorganisms; NOSOCOMIAL infections; BACTERIAL diseases; ANTIBIOTICS; KLEBSIELLA; RETROSPECTIVE studies; KLEBSIELLA infections; MEDICAL records; DISEASE prevalence; SURVIVAL analysis (Biometry); MICROBIAL sensitivity tests; PHARMACODYNAMICS

Publication

Emerging Infectious Diseases, 2020, Vol 26, Issue 2, p289

ISSN

1080-6040

Publication type

Academic Journal

DOI

10.3201/eid2602.190594