PDF(Pubmed)
Abstract：
Klebsiella pneumoniae strains that are resistant to multiple drugs (KPMDRs), which are often acquired in hospital settings and lead to healthcare-associated infections, pose a serious public health threat, as does hypervirulent K. pneumoniae (hvKp), which can also cause serious infections in otherwise healthy individuals. The widespread and often unnecessary use of antibiotics seen during the recent COVID-19 pandemic has exacerbated the challenges posed by antibiotic resistance in clinical settings. There is growing concern that hypervirulent (hvKp) strains may acquire genes that confer antimicrobial resistance, thus combining an MDR profile with their increased ability to spread to multiple body sites, causing difficult-to-treat infections. This study aimed to compare resistance and virulence profiles in KPC-3-producing K. pneumoniae isolates collected over four years (2020-2023). A genome-based surveillance of all MDR CRE-K. pneumoniae was used to identify genetic differences and to characterize the virulence and resistance profiles. Our results provide a picture of the evolution of resistance and virulence genes and contribute to avoiding the possible spread of isolates with characteristics of multi-drug resistance and increased virulence, which are thought to be one of the main global challenges to public health, within our hospital.
摘要：
对多种药物（KPMDR）耐药的肺炎克雷伯菌菌株，通常在医院环境中获得并导致医疗保健相关感染，构成严重的公共卫生威胁，高毒力肺炎克雷伯菌(HvKp)也是如此，这也可能导致其他健康个体的严重感染。在最近的COVID-19大流行期间，抗生素的广泛使用往往是不必要的，这加剧了临床环境中抗生素耐药性带来的挑战。人们越来越担心高毒力（hvKp）菌株可能会获得赋予抗微生物耐药性的基因，因此，将MDR谱与它们传播到多个身体部位的能力相结合，导致难以治疗的感染。这项研究旨在比较四年（2020-2023年）收集的产KPC-3肺炎克雷伯菌分离株的耐药性和毒力谱。对所有MDRCRE-K进行基于基因组的监测肺炎用于鉴定遗传差异并表征毒力和抗性谱。我们的结果提供了抗性和毒力基因进化的图片，并有助于避免具有多药抗性和毒力增加特征的分离株的可能传播。这被认为是公共卫生面临的主要全球挑战之一，在我们的医院里。
