The mechanisms of resistance, epidemiological characteristics, and molecular evolution of carbapenem-resistant hypervirulent Klebsiella pneumoniae

被引:0
作者
Wang, Qun [1 ]
Ye, Mei-Yi [1 ]
Hong, Chi [1 ]
Li, Zu-Pin [1 ]
Lin, Lei [1 ]
机构
[1] Peoples Hosp Dayi Cty, Dept Clin Lab, Chengdu, Sichuan, Peoples R China
关键词
Klebsiella pneumoniae; carbapenemase; virulence; plasmid; evolutionary mechanism; ST11; SURVEILLANCE; CONVERGENCE; INFECTIONS; EMERGENCE; OXA-48; GENES; HVKP;
D O I
10.1093/labmed/lmae110
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Introduction Carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) is a highly pathogenic, drug-resistant, and transmissible "superbug" that causes infections in hospitals and communities. Because of the lack of effective antimicrobial treatment options, morbidity and mortality from CR-hvKP infections have increased dramatically, and outbreaks and the rapid spread of CR-hvKP in hospitals have become a major global public health challenge.Methods The mechanisms of molecular evolution in CR-hvKP include the acquisition of a hypervirulent plasmid encoding a virulence gene by carbapenemase-producing K pneumoniae, the horizontal transfer of plasmids carrying carbapenem resistance genes to hvKP, and the acquisition of fusion plasmids carrying both carbapenem resistance genes and hypervirulent genes by classic K pneumoniae. In addition, hvKP can develop a resistance phenotype under antibiotic pressure.Results CR-hvKP arises through plasmid-mediated convergence of resistance genes and virulence factors. Its multidrug resistance and lethal pathogenicity fuel hospital outbreaks, requiring urgent action to block plasmid transmission and strengthen surveillance to contain the spread of this evolving superbug.Discussion In this article, we have summarized the carbapenemase resistance mechanism, evolution mechanism, virulence factors, and epidemiology of CR-hvKP. Our aim was to elucidate the molecular evolutionary mechanism of CR-hvKP and provide a reference for curbing the spread of CR-hvKP.
引用
收藏
页码:323 / 335
页数:13
相关论文
共 94 条
[81]   Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae [J].
Xu, Liangfei ;
Sun, Xiaoxi ;
Ma, Xiaoling .
ANNALS OF CLINICAL MICROBIOLOGY AND ANTIMICROBIALS, 2017, 16
[82]   Mobilization of the nonconjugative virulence plasmid from hypervirulent Klebsiella pneumoniae [J].
Xu, Yanping ;
Zhang, Jianfeng ;
Wang, Meng ;
Liu, Meng ;
Liu, Guitian ;
Qu, Hongping ;
Liu, Jialin ;
Deng, Zixin ;
Sun, Jingyong ;
Ou, Hong-Yu ;
Qu, Jieming .
GENOME MEDICINE, 2021, 13 (01)
[83]   Complexity of Genomic Epidemiology of Carbapenem-Resistant Klebsiella pneumoniae Isolates in Colombia Urges the Reinforcement of Whole Genome Sequencing-Based Surveillance Programs [J].
Yamile Saavedra, Sandra ;
Fabian Bernal, Johan ;
Montilla-Escudero, Efrain ;
Alejandra Arevalo, Stefany ;
Andres Prada, Diego ;
Fernanda Valencia, Maria ;
Moreno, Jaime ;
Melissa Hidalgo, Andrea ;
Sofia Garcia-Vega, Angela ;
Abrudan, Monica ;
Argimon, Silvia ;
Kekre, Mihir ;
Underwood, Anthony ;
Aanensen, David M. ;
Duarte, Carolina ;
Donado-Godoy, Pilar .
CLINICAL INFECTIOUS DISEASES, 2021, 73 :S290-S299
[84]   Molecular epidemiology of carbapenem-resistant hypervirulent Klebsiella pneumoniae in China [J].
Yang, Xuemei ;
Sun, Qiaoling ;
Li, Jiaping ;
Jiang, Yu ;
Li, Yi ;
Lin, Jianping ;
Chen, Kaichao ;
Chan, Edward Wai-Chi ;
Zhang, Rong ;
Chen, Sheng .
EMERGING MICROBES & INFECTIONS, 2022, 11 (01) :841-849
[85]   Carbapenem Resistance-Encodinc and Virulence-Encoding Conjugative Plasmids in Klebsiella pneumoniae [J].
Yang, Xuemei ;
Dong, Ning ;
Chan, Edward Wai-Chi ;
Zhang, Rong ;
Chen, Sheng .
TRENDS IN MICROBIOLOGY, 2021, 29 (01) :65-83
[86]   Carriage of distinct blaKPC-2 and blaOXA-48 plasmids in a single ST11 hypervirulent Klebsiella pneumoniae isolate in Egypt [J].
Yang, Yanxian ;
Yang, Yongqiang ;
Ahmed, Mohamed Abd El-Gawad El-Sayed ;
Qin, Mingyang ;
He, Ruowen ;
Wu, Yiping ;
Liang, Xiaoxue ;
Zhong, Lan-Lan ;
Chen, Ping ;
Deng, Baoguo ;
Hassan, Reem Mostafa ;
Wen, Weihong ;
Xu, Lingqing ;
Huang, Xubin ;
Xu, Lin ;
Tian, Guo-Bao .
BMC GENOMICS, 2022, 23 (01)
[87]   Molecular and Epidemiological Characteristics of Carbapenemase-Producing Klebsiella pneumoniae Clinical Isolates in Japan [J].
Yonekawa, Shinsuke ;
Mizuno, Tomoki ;
Nakano, Ryuichi ;
Nakano, Akiyo ;
Suzuki, Yuki ;
Asada, Tomoko ;
Ishii, Ayako ;
Kakuta, Naoki ;
Tsubaki, Kosuke ;
Mizuno, Sayaka ;
Ogawa, Miho ;
Yano, Hisakazu ;
Kasahara, Kei ;
Mikasa, Keiichi .
MSPHERE, 2020, 5 (05)
[88]   Nationwide Surveillance of Clinical Carbapenem-resistant Enterobacteriaceae (CRE) Strains in China [J].
Zhang, Rong ;
Liu, Lizhang ;
Zhou, Hongwei ;
Chan, Edward Waichi ;
Li, Jiaping ;
Fang, Ying ;
Li, Yi ;
Liao, Kang ;
Chen, Sheng .
EBIOMEDICINE, 2017, 19 :98-106
[89]   Emergence of Tigecycline Nonsusceptible and IMP-4 Carbapenemase-Producing K2-ST65 Hypervirulent Klebsiella pneumoniae in China [J].
Zhang, Yawei ;
Wang, Xiaojuan ;
Wang, Qi ;
Chen, Hongbin ;
Li, Henan ;
Wang, Shuyi ;
Wang, Ruobing ;
Wang, Hui .
MICROBIOLOGY SPECTRUM, 2021, 9 (02)
[90]   Evolution of hypervirulence in carbapenem-resistant Klebsiella pneumoniae in China: a multicentre, molecular epidemiological analysis [J].
Zhang, Yawei ;
Jin, Longyang ;
Ouyang, Pengwen ;
Wang, Qi ;
Wang, Ruobing ;
Wang, Juan ;
Gao, Hua ;
Wang, Xiaojuan ;
Wang, Hui ;
Kang, Haiquan ;
Gu, Bing ;
Wang, Chunlei ;
Cao, Bin ;
Yang, Chunxia ;
Jin, Liang ;
Liao, Kang ;
Zhang, Xiaoqian ;
Ma, Xiaobo ;
Xie, Liangyi ;
Zheng, Rui ;
Zou, Hong ;
Wang, Shifu ;
Pei, Fengyan ;
Man, Sijin ;
Li, Wei ;
Zhang, Yumei ;
Cui, Qiaozhen ;
Jia, Xianghong ;
Guo, Dawen ;
Fu, Quan ;
Zhang, Zhijie ;
Guo, Zhusheng ;
Li, Zhenpeng ;
Xu, Yuanyuan ;
Ma, Xiaoling ;
Li, Yang ;
Jin, Yan ;
Liu, Zhiwu ;
Zeng, Ji ;
Li, Xiaoying ;
Zou, Cuimei ;
Ji, Ping ;
Jin, Chunmei ;
Huang, Jiaming ;
Tian, Jinjing ;
Wu, Weiqing ;
Xu, Xichi ;
Wen, Hainan ;
Yuan, Jing .
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2020, 75 (02) :327-336