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Virulence plasmid with IroBCDN deletion promoted cross-regional transmission of ST11-KL64 carbapenem-resistant hypervirulent Klebsiella pneumoniae in central China
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Virulence plasmid with IroBCDN deletion promoted cross-regional transmission of ST11-KL64 carbapenem-resistant hypervirulent Klebsiella pneumoniae in central China
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Virulence plasmid with IroBCDN deletion promoted cross-regional transmission of ST11-KL64 carbapenem-resistant hypervirulent Klebsiella pneumoniae in central China
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Journal Article
Virulence plasmid with IroBCDN deletion promoted cross-regional transmission of ST11-KL64 carbapenem-resistant hypervirulent Klebsiella pneumoniae in central China
2024
Overview
Background
Carbapenem-resistant and hypervirulent
Klebsiella pneumoniae
(CR-hvKP) caused infections of high mortality and brought a serious impact on public health. This study aims to evaluate the epidemiology, resistance and virulence characteristics of CR-hvKP and to identify potential drivers of cross-regional transmission in different regions of China, in order to provide a basis for developing targeted prevention measures.
Methods
Clinical
K. pneumoniae
strains were collected from Jiujiang and Nanchang in Jiangxi province between November 2021 to June 2022. Clinical data of patients (age, sex, source of infection, and diagnosis) were also gathered. We characterized these strains for their genetic relatedness using PFGE, antimicrobial and virulence plasmid structures using whole-genome sequencing, and toxicity using
Galleria mellonella
infection model.
Results
Among 609 strains, 45 (7.4%) CR-hvKP were identified, while the strains.
isolated from Nanchang and Jiujiang accounted for 10.05% (36/358) and 3.59% (9/251). We observed that ST11-KL64 CR-hvKP had an overwhelming epidemic dominance in these two regions. Significant genetic diversity was identified among all ST11-KL64 CR-hvKP cross-regional transmission between Nanchang and Jiujiang and this diversity served as the primary driver of the dissemination of clonal groups. Virulence genes profile revealed that ST11-KL64 CR-hvKP might harbour incomplete pLVPK-like plasmids and primarily evolved from CRKP by acquiring the hypervirulence plasmid. We found the predominance of truncated-IncFIB/IncHI1B type virulence plasmids with a 25 kb fragment deletion that encoded
iroBCDN
clusters.
Conclusion
ST11-KL64 is the most cross-regional prevalent type CR-hvKPs in Jiangxi province, which mainly evolved from CRKPs by acquiring a truncated-IncHI1B/IncFIB virulence plasmid with the deletion of
iroBCDN
. Stricter surveillance and control measures are urgently needed to prevent the epidemic transmission of ST11-KL64 CR-hvKP.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
/ Aged
/ Analysis
/ Animals
/ Anti-Bacterial Agents - pharmacology
/ Bacterial Proteins - genetics
/ Biomedical and Life Sciences
/ Carbapenem-Resistant Enterobacteriaceae - drug effects
/ Carbapenem-Resistant Enterobacteriaceae - genetics
/ Carbapenem-Resistant Enterobacteriaceae - isolation & purification
/ Carbapenem-Resistant Enterobacteriaceae - pathogenicity
/ Carbapenem-resistant hypervirulent Klebsiella pneumoniae
/ China
/ Complications and side effects
/ Deletion
/ Female
/ Genes
/ Genomes
/ Genomics
/ Humans
/ Imipenem
/ Klebsiella Infections - epidemiology
/ Klebsiella Infections - microbiology
/ Klebsiella Infections - transmission
/ Klebsiella pneumoniae - drug effects
/ Klebsiella pneumoniae - genetics
/ Klebsiella pneumoniae - isolation & purification
/ Klebsiella pneumoniae - pathogenicity
/ Male
/ MLST
/ Mycology
/ Patients
/ Plasmids
/ Toxicity
/ Virology
