Genomic analysis of carbapenem-resistant Klebsiella pneumoniae blood isolates from nationwide surveillance in South Korea

IntroductionCarbapenem-resistant Klebsiella pneumoniae (CRKP) poses a significant threat to public health owing to its multidrug resistance and rapid dissemination.MethodsThis study analyzed CRKP isolates collected from bloodstream infections in nine regions of South Korea using the Kor-GLASS survei...

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Main Authors: Younggwon On, Jung Wook Kim, Juyoung Lee, Jung Sik Yoo
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Microbiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fmicb.2025.1562222/full
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author Younggwon On
Jung Wook Kim
Juyoung Lee
Jung Sik Yoo
author_facet Younggwon On
Jung Wook Kim
Juyoung Lee
Jung Sik Yoo
author_sort Younggwon On
collection DOAJ
description IntroductionCarbapenem-resistant Klebsiella pneumoniae (CRKP) poses a significant threat to public health owing to its multidrug resistance and rapid dissemination.MethodsThis study analyzed CRKP isolates collected from bloodstream infections in nine regions of South Korea using the Kor-GLASS surveillance system between 2017 and 2021.ResultsA total of 3,941 K. pneumoniae isolates were collected. Among them, 119 (3%) isolates were identified as CRKP. Most CRKP (79.7%) belonged to sequence type 307 (ST307), followed by ST11 (6.8%). All CRKP isolates exhibited multidrug resistance, with 78.8% carrying the IncX3 plasmid encoding the KPC-2 gene. Phylogenetic and genomic analyses revealed that ST307 isolates exhibited low single nucleotide polymorphism (SNP) differences. SNP differences among ST307 strains ranged from a minimum of 1 to a maximum of 140, indicating close genetic relatedness. All ST307 strains harbored the KL102 and O1/O2v2 loci, and genomic analysis revealed high prevalence of key resistance genes such as KPC (91.5%) and CTX-M-15 (83.9%), alongside mutations in the QRDR (ParC-80I, GyrA-83I) and ompK genes. Two major clusters were identified, with cluster 1 harboring yersiniabactin lineage 16 (ICEkp12) and cluster 2 showing higher virulence, including the yersiniabactin lineage 17 (ICEkp10) and colibactin-associated genes.DiscussionThese findings underscore the dominance of ST307 among CRKP isolates in Korea, which is driven by clonal expansion and the critical role of mobile genetic elements. Therefore, enhanced genomic surveillance and targeted infection control measures are urgently required to address the spread of CRKP in clinical settings.
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spelling doaj-art-d03bf3197dd64f9e95232a1edb994b1a2025-08-20T02:08:02ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2025-05-011610.3389/fmicb.2025.15622221562222Genomic analysis of carbapenem-resistant Klebsiella pneumoniae blood isolates from nationwide surveillance in South KoreaYounggwon On0Jung Wook Kim1Juyoung Lee2Jung Sik Yoo3Division of Antimicrobial Resistance Research, Center for Infectious Disease, National Institute of Health, Korea, Cheongju, South KoreaDivision of Zoonotic and Vector Borne Diseases Research, Center for Infectious Disease, National Institute of Health, Korea, Cheongju, South KoreaDivision of Biobank for Health Sciences, Department of Future Healthcare, National Institute of Health, Korea, Cheongju, South KoreaDivision of Antimicrobial Resistance Research, Center for Infectious Disease, National Institute of Health, Korea, Cheongju, South KoreaIntroductionCarbapenem-resistant Klebsiella pneumoniae (CRKP) poses a significant threat to public health owing to its multidrug resistance and rapid dissemination.MethodsThis study analyzed CRKP isolates collected from bloodstream infections in nine regions of South Korea using the Kor-GLASS surveillance system between 2017 and 2021.ResultsA total of 3,941 K. pneumoniae isolates were collected. Among them, 119 (3%) isolates were identified as CRKP. Most CRKP (79.7%) belonged to sequence type 307 (ST307), followed by ST11 (6.8%). All CRKP isolates exhibited multidrug resistance, with 78.8% carrying the IncX3 plasmid encoding the KPC-2 gene. Phylogenetic and genomic analyses revealed that ST307 isolates exhibited low single nucleotide polymorphism (SNP) differences. SNP differences among ST307 strains ranged from a minimum of 1 to a maximum of 140, indicating close genetic relatedness. All ST307 strains harbored the KL102 and O1/O2v2 loci, and genomic analysis revealed high prevalence of key resistance genes such as KPC (91.5%) and CTX-M-15 (83.9%), alongside mutations in the QRDR (ParC-80I, GyrA-83I) and ompK genes. Two major clusters were identified, with cluster 1 harboring yersiniabactin lineage 16 (ICEkp12) and cluster 2 showing higher virulence, including the yersiniabactin lineage 17 (ICEkp10) and colibactin-associated genes.DiscussionThese findings underscore the dominance of ST307 among CRKP isolates in Korea, which is driven by clonal expansion and the critical role of mobile genetic elements. Therefore, enhanced genomic surveillance and targeted infection control measures are urgently required to address the spread of CRKP in clinical settings.https://www.frontiersin.org/articles/10.3389/fmicb.2025.1562222/fullantibiotic resistancewhole-genome sequencingnationwidesurveillancecarbapenemgenomic epidemiology
spellingShingle Younggwon On
Jung Wook Kim
Juyoung Lee
Jung Sik Yoo
Genomic analysis of carbapenem-resistant Klebsiella pneumoniae blood isolates from nationwide surveillance in South Korea
Frontiers in Microbiology
antibiotic resistance
whole-genome sequencing
nationwide
surveillance
carbapenem
genomic epidemiology
title Genomic analysis of carbapenem-resistant Klebsiella pneumoniae blood isolates from nationwide surveillance in South Korea
title_full Genomic analysis of carbapenem-resistant Klebsiella pneumoniae blood isolates from nationwide surveillance in South Korea
title_fullStr Genomic analysis of carbapenem-resistant Klebsiella pneumoniae blood isolates from nationwide surveillance in South Korea
title_full_unstemmed Genomic analysis of carbapenem-resistant Klebsiella pneumoniae blood isolates from nationwide surveillance in South Korea
title_short Genomic analysis of carbapenem-resistant Klebsiella pneumoniae blood isolates from nationwide surveillance in South Korea
title_sort genomic analysis of carbapenem resistant klebsiella pneumoniae blood isolates from nationwide surveillance in south korea
topic antibiotic resistance
whole-genome sequencing
nationwide
surveillance
carbapenem
genomic epidemiology
url https://www.frontiersin.org/articles/10.3389/fmicb.2025.1562222/full
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