肺炎克雷伯菌是医院感染和严重社区获得性感染的常见原因。多药耐药(MDR)和高毒力(hv)菌株是主要威胁,追踪它们的出现,MDR和hv性状的进化和新兴趋同具有重要意义。我们采用全基因组测序(WGS)来研究来自北京H301医院的大量纵向临床肺炎克雷伯菌分离株的进化和流行病学。中国。总的来说,人口高度多样化,尽管一些克隆占主导地位。属于克隆组(CG)258的菌株占优势,代表了大多数碳青霉烯酶生产者。CG258菌株表现出很高的多样性,一个克隆,ST11-KL47代表了大多数分离株,并与KPC-2碳青霉烯酶和几种毒力因子高度相关,包括一个毒力质粒.第二个优势克隆是CG23,它是全球主要的hv克隆。虽然它通常对多种抗生素敏感,我们发现一些分离株携带编码ESBLs和碳青霉烯酶的MDR质粒.我们还报道了最近描述的高风险克隆的局部出现,ST383.与通常与KPC-2相关的属于CG258的菌株相反,ST383菌株似乎容易获得不同类型的碳青霉烯酶。此外,我们发现了几个携带高毒力质粒的ST383菌株。总的来说,我们检测到约5%的AMR基因(ESBLs或碳青霉烯酶)和高毒力基因同时携带。追踪这些菌株的出现和进化,导致严重感染,治疗选择有限,是了解它们的起源和进化并限制其传播的基础。本文包含Microreact托管的数据。
Klebsiella pneumoniae is a frequent cause of nosocomial and severe community-acquired infections. Multidrug-resistant (MDR) and hypervirulent (hv) strains represent major threats, and tracking their emergence, evolution and the emerging convergence of MDR and hv traits is of major importance. We employed whole-genome sequencing (WGS) to study the evolution and epidemiology of a large longitudinal collection of clinical K. pneumoniae isolates from the H301 hospital in Beijing,
China. Overall, the population was highly diverse, although some clones were predominant. Strains belonging to clonal group (CG) 258 were dominant, and represented the majority of carbapenemase-producers. While CG258 strains showed high diversity, one clone, ST11-KL47, represented the majority of isolates, and was highly associated with the KPC-2 carbapenemase and several virulence factors, including a virulence plasmid. The second dominant clone was CG23, which is the major hv clone globally. While it is usually susceptible to multiple antibiotics, we found some isolates harbouring MDR plasmids encoding for ESBLs and carbapenemases. We also reported the local emergence of a recently described high-risk clone,
ST383. Conversely to strains belonging to CG258, which are usually associated to KPC-2,
ST383 strains seem to readily acquire carbapenemases of different types. Moreover, we found several
ST383 strains carrying the hypervirulence plasmid. Overall, we detected about 5 % of simultaneous carriage of AMR genes (ESBLs or carbapenemases) and hypervirulence genes. Tracking the emergence and evolution of such strains, causing severe infections with limited treatment options, is fundamental in order to understand their origin and evolution and to limit their spread. This article contains data hosted by Microreact.