Genomic epidemiology study of Klebsiella pneumoniae causing bloodstream infections in China

• Published in: Clinical and translational medicine 2021-11, Vol.11 (11), p.e624-n/a
• Main Authors: Jia, Xinmiao, Li, Cuidan, Chen, Fei, Li, Xue, Jia, Peiyao, Zhu, Ying, Sun, Tianshu, Hu, Fupin, Jiang, Xiaofeng, Yu, Yunsong, Hu, Bijie, Yang, Qing, Kang, Mei, Liang, Hongjie, Liao, Kang, Hu, Longhua, Gu, Li, Jin, Yan, Duan, Qiong, Zhang, Shufang, Sun, Ziyong, Huang, Wenxiang, He, Hong, Shao, Haifeng, Shan, Bin, Zhuo, Chao, Ji, Ping, Zheng, Rui, Li, Gang, Xu, Yingchun, Yang, Qiwen
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antimicrobial agents; Child; Child, Preschool; China - epidemiology; Conflicts of interest; Drug resistance; Epidemiology; Female; Genes; Genotype & phenotype; Humans; Infant; Klebsiella Infections - epidemiology; Klebsiella pneumoniae - genetics; Klebsiella pneumoniae - pathogenicity; Letter to Editor; Male; Middle Aged; Sepsis - epidemiology; Sepsis - etiology; Sepsis - microbiology; Virulence
• ISSN: 2001-1326; 2001-1326
• DOI: 10.1002/ctm2.624

Dear Editor, Klebsiella pneumoniae (K. pneumoniae, Kpn) bloodstream infection (BSI) has a considerable prevalence and high mortality worldwide.1–3 The emergence of carbapenem-resistant BSI-Kpns, especially those with hypervirulence, poses a challenge for BSI-Kpn control worldwide.4–6 We conducted a large-scale multicenter epidemiological study and in-depth genomic analysis of BSI-Kpns in China, describing a complete molecular epidemiological picture (clinical features, sequence types (STs)/serotypes, antimicrobial resistance/hypervirulence, phenotype/genotype) of BSI-Kpns. Importantly, most ST11 strains were K64/O2v1 (49/65, 75.38%) and K47/OL101(14/65, 21.54%), all ST23 strains were K1/O1v2 and all ST65 strains were K2/O1v2 (Figure 1C,D; Figure S3). [...]strains of the same ST clustered in the same evolutionary branch and strains of different serotypes clustered in different sub-branches inside of the same ST (Figure 1D). [...]the values of C-reactive protein (CRP), neutrophil percent (NEU) and total white blood cells in CR/CS-HvKPs, especially CRP, were significantly higher than those in CR/CS-cKPs (Figure 3E–G). [...]correlation analysis between antimicrobial-resistance/virulence genes and clinical symptoms (Figure S10) indicated that antimicrobial resistance genes, especially blaKPC-2 and quinolone resistance mutations, had a significantly positive correlation with ICU admission and final prognosis but a significantly negative correlation with the BSI type of CO (Figure S10A,C).