Clinical imipenem non-susceptible Klebsiella pneumoniae isolates from China: Epidemiology, molecular characterization and in vitro activity of imipenem/relebactam

Objective: To describe the epidemiological and molecular characterization and in vitro activity of imipenem/relebactam against imipenem non-susceptible (IPMNS) Klebsiella pneumoniae isolates in China. Methods: K. pneumoniae isolates were collected from 16 sites in 5 regions across China during 2019....

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Main Authors: Peiyao Jia, Pengcheng Li, Wei Yu, Xiaobing Chu, Hui Zhang, Jingjia Zhang, Wei Kang, Ge Zhang, Qian Zhang, Shiyu Chen, Yingchun Xu, Qiwen Yang
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Journal of Global Antimicrobial Resistance
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213716525001146
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author Peiyao Jia
Pengcheng Li
Wei Yu
Xiaobing Chu
Hui Zhang
Jingjia Zhang
Wei Kang
Ge Zhang
Qian Zhang
Shiyu Chen
Yingchun Xu
Qiwen Yang
author_facet Peiyao Jia
Pengcheng Li
Wei Yu
Xiaobing Chu
Hui Zhang
Jingjia Zhang
Wei Kang
Ge Zhang
Qian Zhang
Shiyu Chen
Yingchun Xu
Qiwen Yang
author_sort Peiyao Jia
collection DOAJ
description Objective: To describe the epidemiological and molecular characterization and in vitro activity of imipenem/relebactam against imipenem non-susceptible (IPMNS) Klebsiella pneumoniae isolates in China. Methods: K. pneumoniae isolates were collected from 16 sites in 5 regions across China during 2019. Antimicrobial susceptibility testing was performed. For IPMNS K. pneumoniae isolates, whole genome sequencing was used to screen for drug-resistance and virulence genes. Results: Of 1011 clinical K. pneumoniae isolates, 277 (27.3%) were IPMNS and were significantly more common in intensive care unit patients (47.5%) and hospital-acquired infections (28.9%). Production of carbapenemase was the dominant resistance mechanism, with 228 (89.8%) IPMNS isolates harbouring blaKPC-2, 8 (3.1%) blaNDM, 2 (0.8%) blaOXA-232 and 1 (0.4%) blaOXA-181. The dominant clone was sequence type (ST) 11 (78.7%) followed by ST15 (10.2%). Relebactam restored imipenem’s susceptibility in 96.5% isolates harbouring a blaKPC-2 gene. Conclusions: Harbouring the blaKPC-2 gene was the dominant mechanism of IPMNS K. pneumoniae in China. Empirical imipenem/relebactam treatment could be considered when susceptibility or carbapenemase tests are not available.
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spelling doaj-art-e31b250ada0c4aaf92c970ec3356989c2025-08-20T03:45:18ZengElsevierJournal of Global Antimicrobial Resistance2213-71652025-09-01441710.1016/j.jgar.2025.05.011Clinical imipenem non-susceptible Klebsiella pneumoniae isolates from China: Epidemiology, molecular characterization and in vitro activity of imipenem/relebactamPeiyao Jia0Pengcheng Li1Wei Yu2Xiaobing Chu3Hui Zhang4Jingjia Zhang5Wei Kang6Ge Zhang7Qian Zhang8Shiyu Chen9Yingchun Xu10Qiwen Yang11Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaValue & Implementation, Global Medical & Scientific Affairs, MSD China, Shanghai, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Corresponding author. Mailing address. Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing Street, Beijing 100730, China.Objective: To describe the epidemiological and molecular characterization and in vitro activity of imipenem/relebactam against imipenem non-susceptible (IPMNS) Klebsiella pneumoniae isolates in China. Methods: K. pneumoniae isolates were collected from 16 sites in 5 regions across China during 2019. Antimicrobial susceptibility testing was performed. For IPMNS K. pneumoniae isolates, whole genome sequencing was used to screen for drug-resistance and virulence genes. Results: Of 1011 clinical K. pneumoniae isolates, 277 (27.3%) were IPMNS and were significantly more common in intensive care unit patients (47.5%) and hospital-acquired infections (28.9%). Production of carbapenemase was the dominant resistance mechanism, with 228 (89.8%) IPMNS isolates harbouring blaKPC-2, 8 (3.1%) blaNDM, 2 (0.8%) blaOXA-232 and 1 (0.4%) blaOXA-181. The dominant clone was sequence type (ST) 11 (78.7%) followed by ST15 (10.2%). Relebactam restored imipenem’s susceptibility in 96.5% isolates harbouring a blaKPC-2 gene. Conclusions: Harbouring the blaKPC-2 gene was the dominant mechanism of IPMNS K. pneumoniae in China. Empirical imipenem/relebactam treatment could be considered when susceptibility or carbapenemase tests are not available.http://www.sciencedirect.com/science/article/pii/S2213716525001146Klebsiella pneumoniaeImipenem/relebactamImipenem non-susceptibleEpidemiology
spellingShingle Peiyao Jia
Pengcheng Li
Wei Yu
Xiaobing Chu
Hui Zhang
Jingjia Zhang
Wei Kang
Ge Zhang
Qian Zhang
Shiyu Chen
Yingchun Xu
Qiwen Yang
Clinical imipenem non-susceptible Klebsiella pneumoniae isolates from China: Epidemiology, molecular characterization and in vitro activity of imipenem/relebactam
Journal of Global Antimicrobial Resistance
Klebsiella pneumoniae
Imipenem/relebactam
Imipenem non-susceptible
Epidemiology
title Clinical imipenem non-susceptible Klebsiella pneumoniae isolates from China: Epidemiology, molecular characterization and in vitro activity of imipenem/relebactam
title_full Clinical imipenem non-susceptible Klebsiella pneumoniae isolates from China: Epidemiology, molecular characterization and in vitro activity of imipenem/relebactam
title_fullStr Clinical imipenem non-susceptible Klebsiella pneumoniae isolates from China: Epidemiology, molecular characterization and in vitro activity of imipenem/relebactam
title_full_unstemmed Clinical imipenem non-susceptible Klebsiella pneumoniae isolates from China: Epidemiology, molecular characterization and in vitro activity of imipenem/relebactam
title_short Clinical imipenem non-susceptible Klebsiella pneumoniae isolates from China: Epidemiology, molecular characterization and in vitro activity of imipenem/relebactam
title_sort clinical imipenem non susceptible klebsiella pneumoniae isolates from china epidemiology molecular characterization and in vitro activity of imipenem relebactam
topic Klebsiella pneumoniae
Imipenem/relebactam
Imipenem non-susceptible
Epidemiology
url http://www.sciencedirect.com/science/article/pii/S2213716525001146
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