Chasing the landscape for intrahospital transmission and evolution of hypervirulent carbapenem-resistant Klebsiella pneumoniae

Liu, Lizhang1,2,3; Lou, Ningjie1,2,3; Liang, Qiqiang1,2,3; Xiao, Wei1,2,3; Teng, Gaoqin1,2,3; Ma, Jiangang4; Zhang, Huimin5; Huang, Man1,2,3; Feng, Youjun1,2,3,6,7

2023-12-15

10.1016/j.scib.2023.10.038

SCIENCE BULLETIN   影响因子和分区

2095-9273

2095-9281

The spread of hypervirulent carbapenem-resistant Klebsiella pneumoniae (Hv-CRKP) is a global health concern. Here, we report the intrahospital colonization and spread of Hv-CRKP isolates in a tertiary hospital from 2017 to 2022. Analyses of 90 nonredundant CRKP isolates from 72 patients indicated that Hv-CRKP transferability relies on the dominant ST11-K64 clone. Whole-genome sequencing of 11 representative isolates gave 31 complete plasmid sequences, including 12 KPC-2 resistance carriers and 10 RmpA virulence vehicles. Apart from the binary vehicles, we detected two types of fusion plasmids, favoring the cotransfer of RmpA virulence and KPC-2 resistance. The detection of ancestry/relic plasmids enabled us to establish genetic mechanisms by which rare fusion plasmids form. Unexpectedly, we found a total of five rmpA promoter variants (P9T-P13T) exhibiting distinct activities and varying markedly in their geographic distributions. CRISPR/Cas9 manipulation confirmed that an active PT11-rmpA regulator is a biomarker for the "high-risk" ST11-K64/CRKP clone. These findings suggest clonal spread and clinical evolution of the prevalent ST11-K64/Hv-CRKP clones. Apart from improved public awareness of Hv-CRKP convergence, our findings might benefit the development of surveillance (and/or intervention) strategies for the dominant ST11-K64 lineage of the Hv-CRKP population in healthcare sectors.(c) 2023 Science China Press. Published by Elsevier B.V. and Science China Press. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Carbapenem-resistant Klebsiella pneumoniae Hypervirulent CRKP ST11-K64 Intrahospital evolution Fusion plasmid rmpA promoter

SCI

英语

通讯

National Natural Science Foundation of China["32141001","31830001"] ; National Science Fund for Distinguished Young Scholars[32125003] ; National Key R&D Program of China["2022YFC2303900","2022YFC3704700"]

Science & Technology - Other Topics

Multidisciplinary Sciences

WOS:001146441000001

ELSEVIER

Web of Science

1.Zhejiang Univ, Sch Med, Key Lab Multiple Organ Failure, Minist Educ, Hangzhou 310058, Peoples R China
2.Zhejiang Univ, Affiliated Hosp 2, Sch Med, Dept Microbiol, Hangzhou 310058, Peoples R China
3.Zhejiang Univ, Sch Med, Affiliated Hosp 2, Gen Intens Care Unit, Hangzhou 310058, Peoples R China
4.Zhejiang Acad Agr Sci, Hangzhou 310021, Peoples R China
5.Univ Illinois, Canc Ctr Illinois, Urbana, IL 61801 USA
6.Southern Univ Sci & Technol, Shenzhen Peoples Hosp 3, Natl Clin Res Ctr Infect Dis, Dept Clin Lab,Affiliated Hosp 2, Shenzhen 518112, Peoples R China
7.Zhejiang Prov Key Lab Microbial Biochem & Metab En, Hangzhou 310058, Peoples R China

Liu, Lizhang,Lou, Ningjie,Liang, Qiqiang,et al. Chasing the landscape for intrahospital transmission and evolution of hypervirulent carbapenem-resistant Klebsiella pneumoniae[J]. SCIENCE BULLETIN,2023,68(23).

Liu, Lizhang.,Lou, Ningjie.,Liang, Qiqiang.,Xiao, Wei.,Teng, Gaoqin.,...&Feng, Youjun.(2023).Chasing the landscape for intrahospital transmission and evolution of hypervirulent carbapenem-resistant Klebsiella pneumoniae.SCIENCE BULLETIN,68(23).

Liu, Lizhang,et al."Chasing the landscape for intrahospital transmission and evolution of hypervirulent carbapenem-resistant Klebsiella pneumoniae".SCIENCE BULLETIN 68.23(2023).