Abstract：
Klebsiella pneumoniae infection and antimicrobial resistance among children are major concerns. The occurrence of hypervirulent K. pneumoniae (hvKp) infections is gradually increasing worldwide, and disinfectant resistance is also being reported. Carbapenem- and disinfectant-resistant hvKp infection has made clinical treatment and nosocomial infection control among children increasingly challenging. In this study, whole-genome sequencing was conducted among 34 Carba NP-positive carbapenem-resistant K. pneumoniae (CRKP) strains, and the distribution of antibiotic resistance genes, virulence genes and disinfectant resistance genes was determined. Eleven distinct STs were identified, and most of them were ST11 (58.8%). Among the carbapenem resistance genes, KPC-2 was predominant (61.8%), followed by NDM-1 (26.5%) and IPM-4 (11.8%), and no other carbapenemase genes were found. Twelve virulence genes were investigated. All 34 CRKP strains carried the following virulence genes: rcsA/B, entA, fimA/H and mrkA/D. The gene iucB was present in only 3 (8.9%) CRKP strains. The positive detection rates of the iroN and ybtA genes were 94.1% and 64.7%, respectively. None of the strains was found to carry the rmpA and iroB genes. Two disinfectant resistance genes were investigated in this study. Twenty-one (61.8%) strains carried both the qacE and cepA disinfectant resistance genes, 13 (38.2%) CRKP strains carried only the cepA gene, and no strains with only the qacE gene was detected. The correlations among virulence, drug resistance and disinfectant tolerance showed that the virulence and disinfectant resistance genes were distinct among several types of carbapenemase-producing CRKP strains.
摘要：
儿童肺炎克雷伯菌感染和抗生素耐药性是主要问题。高毒力肺炎克雷伯菌（hvKp）感染的发生率在世界范围内逐渐增加，和消毒剂抗性也有报道。耐碳青霉烯酸和消毒剂的hvKp感染使儿童的临床治疗和医院感染控制越来越具有挑战性。在这项研究中,对34株CarbaNP阳性耐碳青霉烯肺炎克雷伯菌（CRKP）菌株进行了全基因组测序，以及抗生素抗性基因的分布，确定了毒力基因和消毒剂抗性基因。确定了11种不同的STs，其中大部分为ST11(58.8%)。在碳青霉烯抗性基因中，KPC-2占主导地位（61.8%），其次是NDM-1(26.5%)和IPM-4(11.8%)，没有发现其他碳青霉烯酶基因。研究了12个毒力基因。所有34株CRKP菌株均携带以下毒力基因：rcsA/B，entA,fimA/H和mrkA/D基因iucB仅存在于3个(8.9%)CRKP菌株中。iroN和ybtA基因的阳性检出率分别为94.1%和64.7%,分别。没有发现菌株携带rmpA和iroB基因。在这项研究中研究了两个消毒剂抗性基因。21株(61.8%)同时携带qacE和cepA消毒剂抗性基因,13株(38.2%)CRKP菌株仅携带cepA基因，并且没有检测到仅具有qacE基因的菌株。毒力之间的相关性，耐药性和消毒剂耐受性表明，几种产生碳青霉烯酶的CRKP菌株的毒力和消毒剂抗性基因不同。
