A global perspective on the convergence of hypervirulence and carbapenem resistance in Klebsiella pneumoniae

Journal of Global Antimicrobial Resistance, Journal Year: 2021, Volume and Issue: 25, P. 26 - 34

Published: March 2, 2021

Hypervirulence and carbapenem resistance have emerged as two distinct evolutionary directions for Klebsiella pneumoniae, which pose a great threat in clinical settings. Multiple virulence factors contribute to hypervirulence, the mechanisms of are complicated. However, more K. pneumoniae strains been identified recent years integrating both phenotypes, resulting devastating outcomes. Hypervirulent carbapenem-resistant (CR-hvKP) early 2010s thereafter become increasingly prevalent. CR-hvKP primarily prevalent Asia, especially China, but reported all over world. Mechanisms emergence can be summarised by three patterns: (i) (CRKP) acquiring hypervirulent phenotype; (ii) (hvKP) (iii) hypervirulence hybrid plasmid. With their global dissemination, continued surveillance should highly prioritised.

Language: Английский

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ESKAPE pathogens: antimicrobial resistance, epidemiology, clinical impact and therapeutics

Nature Reviews Microbiology, Journal Year: 2024, Volume and Issue: 22(10), P. 598 - 616

Published: June 3, 2024

Language: Английский

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Virulence evolution, molecular mechanisms of resistance and prevalence of ST11 carbapenem-resistant Klebsiella pneumoniae in China: A review over the last 10 years

Journal of Global Antimicrobial Resistance, Journal Year: 2020, Volume and Issue: 23, P. 174 - 180

Published: Sept. 21, 2020

Sequence type 11 (ST11) carbapenem-resistant Klebsiella pneumoniae (CRKP) has become the dominant clone in China. In this review, we trace prevalence of ST11 CRKP China Antimicrobial Surveillance Network (CHINET), key antimicrobial resistance mechanisms and virulence evolution. The recent emergence hypervirulent K. (CR-hvKP) strains due to acquisition a pLVPK-like plasmid, which may cause severe infections relatively healthy individuals that are difficult treat with current antibiotics, attracted worldwide attention. There is very close linkage among IncF plasmids, NTEKPC Hybrid conjugative plasmids demonstrated readily convert strain CR-hvKP via conjugation. Understanding molecular evolutionary virulence-bearing as well allows improved tracking control such organisms.

Language: Английский

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Prevalence of hypervirulent and carbapenem-resistant Klebsiella pneumoniae under divergent evolutionary patterns

Emerging Microbes & Infections, Journal Year: 2022, Volume and Issue: 11(1), P. 1936 - 1949

Published: July 18, 2022

K1/K2 hvKP strains acquire carbapenem-resistance plasmids, known as CR-hvKp, and carbapenem-resistant Klebsiella pneumoniae (CRKP) obtain virulence recognized hv-CRKP. The two different evolution patterns of hypervirulent combined may lead to their prevalence in hospitals. Our study aimed investigate the hv-CRKP CR-hvKp analyze factors influencing prevalence. We collected 890 K. genomes from GenBank 530 clinical isolates nine found that were more prevalent than both dominated by blaKPC-2 gene. blaKPC-2-carrying plasmids could mobilize non-conjugative hvKp CRKP strains. conserved oriT widespread conjugative helper potential for mobilization plasmids. HvKp with KPC plasmid hardly simultaneously exhibit hypervirulence carbapenem resistance plasmid, we rfaH mutation reduced capsular synthesis increased strain. In summary, this revealed suitable survival hospital settings KPC-producing contributed emergence

Language: Английский

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“Superbugs” with hypervirulence and carbapenem resistance in Klebsiella pneumoniae: the rise of such emerging nosocomial pathogens in China

Science Bulletin, Journal Year: 2023, Volume and Issue: 68(21), P. 2658 - 2670

Published: Sept. 30, 2023

Although hypervirulent Klebsiella pneumoniae (hvKP) can produce community-acquired infections that are fatal in young and adult hosts, such as pyogenic liver abscess, endophthalmitis, meningitis, it has historically been susceptible to antibiotics. Carbapenem-resistant K. (CRKP) is usually associated with urinary tract acquired hospitals, pneumonia, septicemias, soft tissue infections. Outbreaks quick spread of CRKP hospitals have become a major challenge public health due the lack effective antibacterial treatments. In early stages development, HvKP first appear distinct routes. However, lines dividing two pathotypes vanishing currently, advent carbapenem-resistant (CR-hvKP) devastating simultaneously multidrug-resistant, hypervirulent, highly transmissible. Most CR-hvKP cases reported Asian clinical settings, particularly China. Typically, develops when hvKP or acquires plasmids carry either carbapenem-resistance gene virulence gene. Alternatively, classic (cKP) may acquire hybrid plasmid carrying both genes. this review, we provide an overview key antimicrobial resistance mechanisms, factors, presentations, outcomes infection. Additionally, discuss possible evolutionary processes prevalence Given wide occurrence CR-hvKP, continued surveillance control measures organisms should be assigned higher priority.

Language: Английский

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Carbapenem-resistant Klebsiella pneumoniae capsular types, antibiotic resistance and virulence factors in China: a longitudinal, multi-centre study

Nature Microbiology, Journal Year: 2024, Volume and Issue: 9(3), P. 814 - 829

Published: Feb. 29, 2024

Abstract Epidemiological knowledge of circulating carbapenem-resistant Klebsiella pneumoniae (CRKP) is needed to develop effective strategies against this public health threat. Here we present a longitudinal analysis 1,017 CRKP isolates recovered from patients 40 hospitals across China between 2016 and 2020. Virulence gene capsule typing revealed expansion type KL64 (59.5%) alongside decreases in KL47 prevalence. Hypervirulent increased prevalence 28.2% 45.7% Phylogenetic spatiotemporal Beijing Shanghai as transmission hubs accounting for differential geographical strains China. Moderate frequency or O-antigen loss was also detected among isolates. Non-capsular were more susceptible phagocytosis, attenuated during mouse infections, but showed serum resistance biofilm formation. These findings give insight into serotype dynamics, revealing the importance monitoring shifts future development immunological infections.

Language: Английский

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ESKAPE in China: epidemiology and characteristics of antibiotic resistance

Emerging Microbes & Infections, Journal Year: 2024, Volume and Issue: 13(1)

Published: Feb. 15, 2024

The escalation of antibiotic resistance and the diminishing antimicrobial pipeline have emerged as significant threats to public health. ESKAPE pathogens - Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp. were initially identified critical multidrug-resistant bacteria, demanding urgently effective therapies. Despite introduction various new antibiotics adjuvants, such innovative β-lactamase inhibitors, these organisms continue pose substantial therapeutic challenges. People's Republic China, a country facing severe bacterial situation, has undergone series changes findings in recent years terms prevalence, transmission characteristics mechanisms resistant bacteria. increasing levels population mobility not only shaped unique prevalence within China but also indirectly reflected global patterns antibiotic-resistant dissemination. What's more, vast nation, exhibits variations bacteria across different provinces regions. In this review, we examine current epidemiology important group pathogens, delving into relevant recently introduced that impact their clinical utility China.

Language: Английский

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Increase in antioxidant capacity associated with the successful subclone of hypervirulent carbapenem-resistant Klebsiella pneumoniae ST11-KL64

Nature Communications, Journal Year: 2024, Volume and Issue: 15(1)

Published: Jan. 2, 2024

The acquisition of exogenous mobile genetic material imposes an adaptive burden on bacteria, whereas the adaptational evolution virulence plasmids upon entry into carbapenem-resistant Klebsiella pneumoniae (CRKP) and its impact remains unclear. To better understand in CRKP, we characterize utilizing a large genomic data containing 1219 K. from our long-term surveillance publicly accessible databases. Phylogenetic evaluation unveils associations between distinct serotypes. sub-lineage ST11-KL64 CRKP acquires pK2044-like plasmid ST23-KL1 hypervirulent pneumoniae, with 2698 bp region deletion all ST11-KL64. is observed to regulate methionine metabolism, enhance antioxidant capacity, further improve survival macrophages. discards certain sequences ST11-KL64, thereby conferring evolutionary advantage. This work contributes multifaceted understanding provides insight potential causes behind low fitness costs bacteria.

Language: Английский

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Carbapenem-resistant Klebsiella pneumoniae : the role of plasmids in emergence, dissemination, and evolution of a major clinical challenge

Expert Review of Anti-infective Therapy, Journal Year: 2024, Volume and Issue: 22(1-3), P. 25 - 43

Published: Jan. 18, 2024

Introduction Klebsiella pneumoniae is a major agent of healthcare-associated infections and cause some community-acquired infections, including severe bacteremic associated with metastatic abscesses in liver other organs. Clinical relevance compounded by its outstanding propensity to evolve antibiotic resistance. In particular, the emergence dissemination carbapenem resistance K. has posed challenge due few residual treatment options, which have only recently been expanded new agents. The epidemiological success carbapenem-resistant (CR-Kp) mainly linked clonal lineages that produce carbapenem-hydrolyzing enzymes (carbapenemases) encoded plasmids.

Language: Английский

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Multidrug-Resistant Bacteria in the Community

Infectious Disease Clinics of North America, Journal Year: 2020, Volume and Issue: 34(4), P. 709 - 722

Published: Sept. 30, 2020

Language: Английский

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