Novel Subclone of Carbapenem-Resistant Klebsiella pneumoniae Sequence Type 11 with Enhanced Virulence and Transmissibility, China

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    Author
    Zhou, K; Xiao, T; David, S; Wang, Q; Zhou, Y; Guo, L; Aanensen, D; Holt, KE; Thomson, NR; Grundmann, H; ...
    Date
    2020-02-01
    Source Title
    Emerging Infectious Diseases
    Publisher
    CENTERS DISEASE CONTROL & PREVENTION
    University of Melbourne Author/s
    Holt, Kathryn
    Affiliation
    Biochemistry and Molecular Biology
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    Document Type
    Journal Article
    Citations
    Zhou, K., Xiao, T., David, S., Wang, Q., Zhou, Y., Guo, L., Aanensen, D., Holt, K. E., Thomson, N. R., Grundmann, H., Shen, P. & Xiao, Y. (2020). Novel Subclone of Carbapenem-Resistant Klebsiella pneumoniae Sequence Type 11 with Enhanced Virulence and Transmissibility, China. EMERGING INFECTIOUS DISEASES, 26 (2), pp.289-297. https://doi.org/10.3201/eid2602.190594.
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    URI
    http://hdl.handle.net/11343/254161
    DOI
    10.3201/eid2602.190594
    Open Access URL
    Published version
    Abstract
    We aimed to clarify the epidemiologic and clinical importance of evolutionary events that occurred in carbapenem-resistant Klebsiella pneumoniae (CRKP). We collected 203 CRKP causing bloodstream infections in a tertiary hospital in China during 2013-2017. We detected a subclonal shift in the dominant clone sequence type (ST) 11 CRKP in which the previously prevalent capsular loci (KL) 47 had been replaced by KL64 since 2016. Patients infected with ST11-KL64 CRKP had a significantly higher 30-day mortality rate than other CRKP-infected patients. Enhanced virulence was further evidenced by phenotypic tests. Phylogenetic reconstruction demonstrated that ST11-KL64 is derived from an ST11-KL47-like ancestor through recombination. We identified a pLVPK-like virulence plasmid carrying rmpA and peg-344 in ST11-KL64 exclusively from 2016 onward. The pLVPK-like-positive ST11-KL64 isolates exhibited enhanced environmental survival. Retrospective screening of a national collection identified ST11-KL64 in multiple regions. Targeted surveillance of this high-risk CRKP clone is urgently needed.

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