Abstract
BackgroundCarbapenem-resistant hypervirulent Klebsiella pneumoniae strains have recently come into existence worldwide; however, researchers in northeast China are not aware of their clinical features and molecular characteristics.MethodsHere, the molecular and virulent characteristics of 44 carbapenem-resistant K. pneumoniae (CRKP) isolates collected from January 2015 to December 2017 were studied. Multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) were carried out to define the clonal relatedness among the isolates. PCR and capsular serotyping of the virulence-associated genes, as well as biofilm formation and serum complement-mediated killing assays, were employed to determine the virulent potential. The genomic features and associated mobile genetic elements of JmsCRE57 were detected by whole genome sequencing.ResultsThe only positive isolate was JmsCRE57, which belonged to the ST375 serotype K2 that expressed uge, mrkD, fimH, kpn, aerobactin and rmpA virulence-associated genes and showed strong biofilm formation and serum sensitivity. Sequencing results showed that the JmsCRE57 genome mainly consisted of a circular chromosome, three antimicrobial resistant plasmids and a virulent plasmid. The antimicrobial resistant plasmid expressing blaKPC-2, blaCTX-M-15, aph(3″)-Ib, aph(6)-Id, qnrB1, aac(3)-IIa, aac(6′)-Ib-cr, blaOXA-1, blaTEM-1B, catB4, sul2, dfrA14 and blaSHV-99. The virulent plasmid belonged to the IncHI1B group, which is mainly composed of mucoid phenotype genes and siderophore-associated genes. The remaining CRKP strains that expressed uge, fimH, mrkD and kpn virulence-associated genes were not successfully typed.ConclusionOur results provide new insights on the epidemiology of carbapenem-resistant K2 hypervirulent K. pneumoniae ST375 and CRKP ST76 strains in northeast China, which may help control their future outbreaks.
Highlights
Carbapenem-resistant hypervirulent Klebsiella pneumoniae strains have recently come into existence worldwide; researchers in northeast China are not aware of their clinical features and molecular characteristics
Our results provide new insights on the epidemiology of carbapenem-resistant K2 hypervirulent K. pneumoniae ST375 and carbapenem-resistant Klebsiella pneumoniae (CRKP) ST76 strains in northeast China, which may help control their future outbreaks
We address the virulence of CRKP isolates, which will enable us to compare the molecular characteristics and the virulence of the ST76 CRKP strain with the K. pneumoniae carbapenemases (KPC)-2 resistance gene in this region and to provide epidemiological data for patients infected with CRKP
Summary
Carbapenem-resistant hypervirulent Klebsiella pneumoniae strains have recently come into existence worldwide; researchers in northeast China are not aware of their clinical features and molecular characteristics. Klebsiella pneumoniae has become a common pathogen that is often treated in clinical practices It normally causes pneumonia, bacteremia, urinary tract infections, and surgical-site infections in hospitalized patients [1]. With the increasing overuse of common antibiotics, carbapenem-resistant Klebsiella pneumoniae (CRKP) strains have spread worldwide in the past two decades. The hvKP strain gets its name from its ability to cause community-acquired liver abscesses in young, healthy individuals. It may cause extrahepatic complications, including necrotizing fasciitis, endophthalmitis and meningitis [6]. Several virulence factors, including the genes that regulate the mucoid phenotype A (rmpA) and siderophore production (aerobactin), have been shown to be major virulence genes of hvKP
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