Abstract：
The rapid increase of mcr-positive Klebsiella pneumoniae (K. pneumoniae) has received considerable attention and poses a major public health concern. Here, we systematically analyzed the global distribution of mcr-positive K. pneumoniae isolates based on published articles as well as publicly available genomes. Combining strain information from 78 articles and 673 K. pneumoniae genomes, a total of 1000 mcr-positive K. pneumoniae isolates were identified. We found that mcr-positive K. pneumoniae has disseminated widely worldwide, especially in Asia, with a higher diversity of sequence types (STs). These isolates were disseminated in 57 countries and were associated with 12 different hosts. Most of the isolates were found in China and were isolated from human sources. Moreover, MLST analysis showed that ST15 and ST11 accounted for the majority of mcr-positive K. pneumoniae, which deserve sustained attention in further surveillance programs. mcr-1 and mcr-9 were the dominant mcr variants in mcr-positive K. pneumoniae. Furthermore, a Genome-wide association study (GWAS) demonstrated that mcr-1- and mcr-9-producing genomes exhibited different antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs), thereby indicating a distinct evolutionary path. Notably, the phylogenetic analysis suggested that certain mcr-positive K. pneumoniae genomes from various geographical areas and hosts harbored a high degree of genetic similarities (<20 SNPs), suggesting frequent cross-region and cross-host clonal transmission. Overall, our results emphasize the significance of monitoring and exploring the transmission and evolution of mcr-positive K. pneumoniae in the context of \"One health\".
摘要：
mcr阳性肺炎克雷伯菌(K.肺炎）已受到相当多的关注，并引起了重大的公共卫生关注。这里,我们根据已发表的文章以及公开的基因组,系统分析了mcr阳性肺炎克雷伯菌的全球分布.结合来自78篇文章和673个肺炎克雷伯菌基因组的菌株信息，共鉴定出1000株mcr阳性肺炎克雷伯菌分离株.我们发现mcr阳性肺炎克雷伯菌已在世界范围内广泛传播，尤其是在亚洲,具有更高的序列类型(STs)多样性。这些分离株在57个国家传播，并与12个不同的宿主相关。大多数分离株是在中国发现的，是从人类来源中分离出来的。此外，MLST分析显示，ST15和ST11占mcr阳性肺炎克雷伯菌的大多数，在进一步的监测计划中值得持续关注。mcr-1和mcr-9是mcr阳性肺炎克雷伯菌的主要mcr变异体。此外，全基因组关联研究（GWAS）表明，产生mcr-1和mcr-9的基因组表现出不同的抗生素抗性基因（ARGs）和移动遗传元件（MGEs），从而表明了一条独特的进化路径。值得注意的是,系统发育分析表明，来自不同地理区域和宿主的某些mcr阳性肺炎克雷伯菌基因组具有高度的遗传相似性（<20个SNP），提示频繁的跨区域和跨宿主克隆传播。总的来说,我们的结果强调了在“一个健康”背景下监测和探索mcr阳性肺炎克雷伯菌的传播和演变的重要性。
