Virulence evolution, molecular mechanisms of resistance and prevalence of ST11 carbapenem-resistant Klebsiella pneumoniae in China: A review over the last 10 years.

毒力进化,中国耐 ST11 碳青霉烯类肺炎克雷伯菌耐药和流行的分子机制 ： 近 10 年的综述.

• 影响指数: 4.349
• 发表时间: 12 2020
• 来源期刊: J Glob Antimicrob Resist
• DOI: 10.1016/j.jgar.2020.09.004
• PMID: 32971292
• 文章类型: Journal Article
• 中科院分区: Q4
• 方向: 医学
• 作者列表: Liao W,Liu Y,Zhang W

关键词: Carbapenem-resistant Klebsiella pneumoniae; Phylogenetic analysis; Resistance mechanism; ST11; Virulence evolution

Mesh: Carbapenems / pharmacology; China / epidemiology; Evolution, Molecular; Humans; Klebsiella Infections / epidemiology; Klebsiella pneumoniae / genetics; Prevalence; Virulence

Abstract

Sequence type 11 (ST11) carbapenem-resistant Klebsiella pneumoniae (CRKP) has become the dominant clone in China. In this review, we trace the prevalence of ST11 CRKP in the China Antimicrobial Surveillance Network (CHINET), the key antimicrobial resistance mechanisms and virulence evolution. The recent emergence of ST11 carbapenem-resistant hypervirulent K. pneumoniae (CR-hvKP) strains in China due to the acquisition of a pLVPK-like virulence plasmid, which may cause severe infections in relatively healthy individuals that are difficult to treat with current antibiotics, has attracted worldwide attention. There is a very close linkage among IncF plasmids, NTEKPC and ST11 K. pneumoniae in China. Hybrid conjugative virulence plasmids are demonstrated to readily convert a ST11 CRKP strain to a CR-hvKP strain via conjugation. Understanding the molecular evolutionary mechanisms of resistance and virulence-bearing plasmids as well as the prevalence of ST11 CRKP in China allows improved tracking and control of such organisms.