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. 2022 Jun;36(6):e24476.
doi: 10.1002/jcla.24476. Epub 2022 May 6.

Characteristics of ST11 KPC-2-producing carbapenem-resistant hypervirulent Klebsiella pneumoniae causing nosocomial infection in a Chinese hospital

Pengwen Ouyang  1 , Bin Jiang  1 , Na Peng  1 , Juan Wang  2 , Liang Cai  2 , Yi Wu  1 , Jianrong Ye  1 , Yiping Chen  1 , Hao Yuan  1 , Chaochao Tan  1 , Liming Tan  1 , Liangyi Xie  1
Affiliations

Characteristics of ST11 KPC-2-producing carbapenem-resistant hypervirulent Klebsiella pneumoniae causing nosocomial infection in a Chinese hospital

Pengwen Ouyang et al. J Clin Lab Anal. 2022 Jun.

Abstract

Background: The purpose of our study is to analyze the microbiological and clinical characteristics of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) that causes nosocomial infection.

Methods: We collected the carbapenem-resistant K. pneumoniae (CRKP) strains that caused nosocomial infection in a hospital in China and collected the relevant clinical data. We characterized these strains for their antimicrobial and virulence-associated phenotype and genotype and analyzed the clonal relatedness. We screened hypervirulent strains and compared them with non-hypervirulent strains.

Results: We retrospectively analyzed 62 CRKP strains that caused nosocomial infection in a tertiary hospital within 1 year, of which 41 (41/62, 66.1%) CRKP were considered as CR-hvKP. All CR-hvKP strains were multi-drug resistance (MDR) and the vast majority of isolates (39/41, 95.1%) were ST11 KPC-2-producing strains. Two hypermucoviscous isolates and 4 capsular types were found in 41 CR-hvKP. Twenty-nine isolates (29/41, 70.7%) showed hypervirulence in Galleria mellonella infection model. PFGE showed that ST11-KL47 CR-hvKP and ST11-KL64 CR-hvKP exhibited a high degree of clonality, while non-hypervirulent strains were not significant. CR-hvKP had higher positive rates of blaKPC-2 and blaCTX-M-65 and higher levofloxacin resistance (p < 0.001, p = 0.005 and p = 0.046, respectively) when compared to the non-hypervirulent strains. There was no significant difference between the two groups in terms of in-hospital mortality (7/41, 17.1% vs 5/21, 23.8%, p = 0.743).

Conclusion: Our research finds that ST11 KPC-2-producing CR-hvKP is the main type of CRKP that caused nosocomial infection, and clonal spread has occurred. We provide more information about CR-hvKP in health care.

Keywords: Klebsiella pneumoniae; carbapenem resistance; hypervirulence; nosocomial infection.

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Conflict of interest statement

All authors‐none to declare.

Figures

FIGURE 1
FIGURE 1
Routine monitoring of K. pneumoniae and research process of this study
FIGURE 2
FIGURE 2
Carriage of virulence genes, in vivo virulence and antimicrobial resistance features of 41 CR‐hvKP strains. AMK, amikacin; SXT, trimethoprim/sulfamethoxazole; FEP, cefepime; CAZ, ceftazidime; IPM, imipenem; MEM, meropenem; TZP, piperacillin/Tazobactam; LVX, levofloxacin; COL, colistin; TGC, tigecycline
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