Molecular epidemiological analysis and research on resistance and virulence of carbapenem-resistant Klebsiella pneumoniae in a tertiary hospital from 2016 to 2023

Abstract Purpose Carbapenem-resistant Klebsiella pneumoniae (CRKP) represents a significant global threat due to its high prevalence rates and limited therapeutic options. The primary objective of this study was to investigate the clinical distribution and molecular epidemiology of CRKP collected be...

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Main Authors: Xindi Wang, Jinwen Wang, Xudong Jiang, Zhuoyan Huang, Liji Huang, Qing Wei, Lina Zhang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Microbiology
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Online Access:https://doi.org/10.1186/s12866-025-03888-7
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author Xindi Wang
Jinwen Wang
Xudong Jiang
Zhuoyan Huang
Liji Huang
Qing Wei
Lina Zhang
author_facet Xindi Wang
Jinwen Wang
Xudong Jiang
Zhuoyan Huang
Liji Huang
Qing Wei
Lina Zhang
author_sort Xindi Wang
collection DOAJ
description Abstract Purpose Carbapenem-resistant Klebsiella pneumoniae (CRKP) represents a significant global threat due to its high prevalence rates and limited therapeutic options. The primary objective of this study was to investigate the clinical distribution and molecular epidemiology of CRKP collected between 2016 and 2023 from a tertiary care hospital in northern China. Methods Polymerase chain reaction (PCR) assays were used to identify resistance and virulence genes, while various assessments, including the string test and biofilm formation analysis, assessed CRKP’s virulence. Multilocus sequence typing (MLST) and whole-genome sequencing were employed to elucidate strain classification and plasmid characteristics. Results The study identified 100 unique CRKP strains, primarily isolated from neurosurgery and ICU, with sputum as the most common specimen type. The majority of strains harbored bla KPC−2 as the primary resistance mechanism. All CRKP strains harbored a minimum of four virulence genes, with entB, mrkD, fimH, and ybtS being most commonly detected across the isolates. Notably, 66 of 100 strains were classified as carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP). The prevailing sequence type (ST) observed was ST11, with serotype KL47 being most prevalent initially, subsequently supplanted by ST11-KL64. Specific strains harbored bla KPC−2 on IncFII-type plasmids, along with other resistance genes, such as bla TEM−1. KP635_PlasmidB harbors multiple antibiotic resistance genes, and the sequence identity and coverage between KP635_PlasmidA and the NTUH-K2044 virulence plasmid are 99%, which contributes to the formation of a highly virulent and multidrug-resistant strain in KP635. Conclusion The emergence of high resistance and hypervirulence in CRKP requires vigilance, enhanced surveillance, and stringent infection control measures to limit its spread.
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spelling doaj-art-b20eb95acd0949238e1bbd2b28327efc2025-08-20T02:17:53ZengBMCBMC Microbiology1471-21802025-04-0125111410.1186/s12866-025-03888-7Molecular epidemiological analysis and research on resistance and virulence of carbapenem-resistant Klebsiella pneumoniae in a tertiary hospital from 2016 to 2023Xindi Wang0Jinwen Wang1Xudong Jiang2Zhuoyan Huang3Liji Huang4Qing Wei5Lina Zhang6Department of Laboratory Medicine, Daqing Oilfield General HospitalDepartment of Laboratory Medicine, Daqing Oilfield General HospitalDepartment of Laboratory Medicine, Daqing Oilfield General HospitalDepartment of Laboratory Medicine, Second Affiliated Hospital of Heilongjiang University of Traditional Chinese MedicineDepartment of Laboratory Medicine, Liuzhou Traditional Chinese Medicine HospitalJiamusi UniversityDepartment of Laboratory Medicine, Daqing Oilfield General HospitalAbstract Purpose Carbapenem-resistant Klebsiella pneumoniae (CRKP) represents a significant global threat due to its high prevalence rates and limited therapeutic options. The primary objective of this study was to investigate the clinical distribution and molecular epidemiology of CRKP collected between 2016 and 2023 from a tertiary care hospital in northern China. Methods Polymerase chain reaction (PCR) assays were used to identify resistance and virulence genes, while various assessments, including the string test and biofilm formation analysis, assessed CRKP’s virulence. Multilocus sequence typing (MLST) and whole-genome sequencing were employed to elucidate strain classification and plasmid characteristics. Results The study identified 100 unique CRKP strains, primarily isolated from neurosurgery and ICU, with sputum as the most common specimen type. The majority of strains harbored bla KPC−2 as the primary resistance mechanism. All CRKP strains harbored a minimum of four virulence genes, with entB, mrkD, fimH, and ybtS being most commonly detected across the isolates. Notably, 66 of 100 strains were classified as carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP). The prevailing sequence type (ST) observed was ST11, with serotype KL47 being most prevalent initially, subsequently supplanted by ST11-KL64. Specific strains harbored bla KPC−2 on IncFII-type plasmids, along with other resistance genes, such as bla TEM−1. KP635_PlasmidB harbors multiple antibiotic resistance genes, and the sequence identity and coverage between KP635_PlasmidA and the NTUH-K2044 virulence plasmid are 99%, which contributes to the formation of a highly virulent and multidrug-resistant strain in KP635. Conclusion The emergence of high resistance and hypervirulence in CRKP requires vigilance, enhanced surveillance, and stringent infection control measures to limit its spread.https://doi.org/10.1186/s12866-025-03888-7Carbapenem-resistant Klebsiella pneumoniaeWhole-genome sequencingHigh virulenceResistancePlasmid
spellingShingle Xindi Wang
Jinwen Wang
Xudong Jiang
Zhuoyan Huang
Liji Huang
Qing Wei
Lina Zhang
Molecular epidemiological analysis and research on resistance and virulence of carbapenem-resistant Klebsiella pneumoniae in a tertiary hospital from 2016 to 2023
BMC Microbiology
Carbapenem-resistant Klebsiella pneumoniae
Whole-genome sequencing
High virulence
Resistance
Plasmid
title Molecular epidemiological analysis and research on resistance and virulence of carbapenem-resistant Klebsiella pneumoniae in a tertiary hospital from 2016 to 2023
title_full Molecular epidemiological analysis and research on resistance and virulence of carbapenem-resistant Klebsiella pneumoniae in a tertiary hospital from 2016 to 2023
title_fullStr Molecular epidemiological analysis and research on resistance and virulence of carbapenem-resistant Klebsiella pneumoniae in a tertiary hospital from 2016 to 2023
title_full_unstemmed Molecular epidemiological analysis and research on resistance and virulence of carbapenem-resistant Klebsiella pneumoniae in a tertiary hospital from 2016 to 2023
title_short Molecular epidemiological analysis and research on resistance and virulence of carbapenem-resistant Klebsiella pneumoniae in a tertiary hospital from 2016 to 2023
title_sort molecular epidemiological analysis and research on resistance and virulence of carbapenem resistant klebsiella pneumoniae in a tertiary hospital from 2016 to 2023
topic Carbapenem-resistant Klebsiella pneumoniae
Whole-genome sequencing
High virulence
Resistance
Plasmid
url https://doi.org/10.1186/s12866-025-03888-7
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