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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Expansion and transmission dynamics of high risk carbapenem-resistant Klebsiella pneumoniae subclones in China: An epidemiological, spatial, genomic analysis

Drug Resistance Updates, Journal Year: 2024, Volume and Issue: 74, P. 101083 - 101083

Published: March 29, 2024

Carbapenem-resistant Klebsiella pneumonia (CRKP) is a global threat that varies by region. The distribution, evolution, and clinical implications of the ST11 CRKP clone remain obscure. We conducted multicenter molecular epidemiological survey using isolates obtained from 28 provinces municipalities across China between 2011 2021. integrated sequences public databases performed genetic epidemiology analysis CRKP. Among CRKP, KL64 serotypes exhibited considerable expansion, increasing 1.54% to 46.08% Combining our data with databases, phylogenetic phylogeography analyses indicated appeared in Americas 1996 spread worldwide, key clones progressing China's southeastern coast inland 2010. Global showed has evolved virulent, resistant clade notable regional spread. Single-nucleotide polymorphism (SNP) identified BMPPS (bmr3, mltC, pyrB, ppsC, sdaC) as marker for this clade. SNP associated high mortality strong anti-phagocytic competitive traits vitro. high-risk subclone expansion potential survival advantages, probably owing factors.

Language: Английский

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Intricate interplay of CRISPR-Cas systems, anti-CRISPR proteins, and antimicrobial resistance genes in a globally successful multi-drug resistant Klebsiella pneumoniae clone

Genome Medicine, Journal Year: 2025, Volume and Issue: 17(1)

Published: Jan. 30, 2025

Language: Английский

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Transmission Dynamics and Novel Treatments of High Risk Carbapenem-Resistant Klebsiella pneumoniae: The Lens of One Health

Pharmaceuticals, Journal Year: 2024, Volume and Issue: 17(9), P. 1206 - 1206

Published: Sept. 12, 2024

The rise of antibiotic resistance and the dwindling antimicrobial pipeline have emerged as significant threats to public health. emergence carbapenem-resistant

Language: Английский

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Understanding carbapenem-resistant hypervirulent Klebsiella pneumoniae: Key virulence factors and evolutionary convergence

hLife, Journal Year: 2024, Volume and Issue: unknown

Published: June 1, 2024

The emergence of hypervirulence (hv) and carbapenem resistance (CR) as distinct evolutionary directions for Klebsiella pneumoniae presents a significant threat in clinical settings. However, recent years, there has been growing identification K. strains that integrate both phenotypes, resulting severe outcomes. Carbapenem-resistant hypervirulent (CRhvKP) typically emerges through the acquisition plasmids carrying either virulence or CR-encoded genes by carbapenem-resistant pneumoniae. Furthermore, hybrid plasmid can confer combination CR hv. CRhvKP cause variety infections, including pneumonia, urinary tract bloodstream liver abscesses, other related conditions. While sequence type 11 (ST11) dominates majority China, molecular factors responsible success ST11 largely remain unknown. Here, we provide an overview current understanding variation distribution crucial determinants, mechanisms driving merging hv CR, potential influencing epidemiological CRhvKP. This research aims to contribute comprehensive complexities surrounding It is imperative underscore development therapies, precision medicine, vaccine strategies pivotal approaches effectively combating Considering widespread prevalence CRhvKP, prioritized, multifaceted approach encompassing infection control, active surveillance, innovative therapeutics essential.

Language: Английский

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Emergence and clinical challenges of ST11-K64 carbapenem-resistant Klebsiella pneumoniae: molecular insights and implications for antimicrobial resistance and virulence in Southwest China

BMC Infectious Diseases, Journal Year: 2025, Volume and Issue: 25(1)

Published: Jan. 3, 2025

In clinical practice, the emergence of ST11-K64 carbapenem-resistant Klebsiella pneumoniae (ST11-K64 CRKP) has become increasingly alarming. Despite this trend, limited research been conducted to elucidate and molecular characteristics these strains. This study aimed comprehensively investigate characteristics, antimicrobial resistance patterns, virulence-associated genes, epidemiology CRKP in Southwest China. A retrospective analysis was performed on patients infected with (CRKP) a tertiary care hospital between July 2021 May 2022. total 69 strains were isolated, data collected for detailed analysis. Laboratory assessments included susceptibility testing, hypermucoviscosity string genotypic characterization virulence multi-locus sequence typing. Statistical analyses using SPSS, significance set at P < 0.05. Among isolates, 36 (52.2%) identified as CRKP. Hematological diseases less associated infection compared non-ST11-K64 (P = 0.012). However, central intravenous catheter use 0.001), mechanical ventilation 0.002), tracheal intubation 0.006), tracheotomy 0.041) significantly more common cases. Resistance rates amikacin gentamicin 0.004), tobramycin 0.034), sulfamethoxazole 0.001) higher Additionally, resistance-associated genes such blaKPC−2 including rmpA iucA rmpA2 iutA detected Furthermore, ST11-K47 CRKP, harbored 0.007), 0.003). Our findings underscore rising prevalence characterized by high levels presence potent genes. strain poses significant therapeutic challenge, necessitating heightened vigilance, stringent control measures, robust management strategies.

Language: Английский

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Increasing polymyxin resistance in clinical carbapenem-resistant Klebsiella pneumoniae strains in China between 2000 and 2023

Communications Medicine, Journal Year: 2025, Volume and Issue: 5(1)

Published: March 11, 2025

Development of polymyxin resistance in carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a severe challenge to public health. Here we aimed perform retrospective study prevalence and molecular characteristics polymyxin-resistant CRKP strains. 4455 clinical strains from 18 provinces China during 2000 2023 were collected. Polymyxin-resistant subjected antimicrobial susceptibility testing, whole genome sequencing bioinformatic analysis. Molecular mechanisms underlying the analyzed. show that emerge initially 2014, such then increase steadily over years, reaching rate 9.86% 2023. In total, 112 isolates are identified. Antimicrobial tests all resistant commonly used antibiotics, yet most remain susceptible only ceftazidime-avibactam tigecycline. Predominant mechanism is mutations mgrB (59/112), which involves disruption by insertion elements as ISKpn26 (20/59), IS903B (14/59), ISKpn14 (9/59). Phylogenetic analysis reveals frequent clonal dissemination within same hospital even among different hospitals neighboring provinces. pLVPK-like virulence plasmids detected 46 isolates, therefore categorized hypervirulent K. may cause infections with high mortality. Our results highlight transmission hospitals. Continuous surveillance should be implemented prevent further settings China. Polymyxins antibiotics treat do not respond other antibiotic treatments. These described multidrug-resistant infections. However, an increasing number cannot successfully treated polymyxins consequence these being caused bacteria killed treatment. We studied had across 20-year period. found became more common areas. This indicates monitoring undertaken detect presence this bacteria, approaches taken spread bacteria. Xie, Zhang et al. conduct epidemiological They find

Language: Английский

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Epidemiology of carbapenem-resistant Klebsiella pneumoniae in China and the evolving trends of predominant clone ST11: a multicentre, genome-based study

Journal of Antimicrobial Chemotherapy, Journal Year: 2024, Volume and Issue: 79(9), P. 2292 - 2297

Published: July 13, 2024

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major nosocomial infectious pathogen with rapidly increasing prevalence. The genomic epidemiological characteristics of CRKP nationwide, especially the evolving trends within predominant clones, should be evaluated clearly.

Language: Английский

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The Origins of ST11 KL64 Klebsiella pneumoniae: a Genome-Based Study

Microbiology Spectrum, Journal Year: 2023, Volume and Issue: 11(2)

Published: March 27, 2023

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major severe threat for human health, and its spread largely driven by few dominant lineages defined sequence types (ST) capsular (KL) types. ST11-KL64 one such lineage that particularly common in China but also has worldwide distribution. However, the population structure origin of K. remain to be determined. We retrieved all genomes (n = 13,625, as June 2022) from NCBI, comprising 730 strains. Phylogenomic analysis core-genome single-nucleotide polymorphisms identified two clades (I II) plus an additional singleton ST11-KL64. performed dated ancestral reconstruction using BactDating found clade I likely emerged 1989 Brazil, while II around 2008 eastern China. then investigated phylogenomic approach combined with potential recombination regions. hybrid 91.2% (ca. 4.98 Mb) chromosome derived ST11-KL15 8.8% (483 kb) acquired ST147-KL64. In contrast, was ST11-KL47 swapping 157-kb region (3% chromosome) containing capsule gene cluster clonal complex 1764 (CC1764)-KL64. The evolved 126-kb I. conclusion, heterogenous different origins countries at time points. IMPORTANCE globally associated increased lengths hospital stay high mortality affected patients. CRKP lineages, including ST11-KL64, type Here, we tested hypothesis single genomic performing genome-based study. comprises clades, which years. particular, have KL64 various sources. Our study underscores chromosomal hot spot pneumoniae. This represents evolutionary mechanism employed some bacteria rapid evolution novel accommodate stress survival.

Language: Английский

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Genetic, virulence, and antimicrobial resistance characteristics associated with distinct morphotypes in ST11 carbapenem-resistant Klebsiella pneumoniae

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

Published: May 12, 2024

ST11 is the most common lineage among carbapenem-resistant Klebsiella pneumoniae (CRKP) infections in Asia. Diverse morphotypes resulting from genetic mutations are associated with significant differences microbial characteristics K. isolates. Here, we investigated determinants and critical distinct of CRKP. An ST11-KL47 CRKP isolate carrying a pLVPK-like virulence plasmid was isolated patient bloodstream infection; had "mcsw" morphotype. Two ("ntrd" "msdw") were derived this strain during vitro passage. Whole genome sequencing used to identify that cause Transmission electron microscopy, antimicrobial susceptibility tests, growth assays, biofilm formation, membrane permeability RNA-seq analysis investigate specific different Compared parental mcsw morphotype, ntrd morphotype resulted mutation genes involved capsular polysaccharide biosynthesis (wza, wzc, wbaP), result validated by gene knockout experiments. This showed capsule deficiency lower potential, but higher production. By contrast, msdw displayed competition increased chlorhexidine polymyxin B. Further analyses indicated these caused interruption sigma factor rpoN insertion deletion gene, which attenuated integrity presumably downregulating phage shock protein operon. These data expand current understanding genetic, virulence, resistance

Language: Английский

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