Prevalence and molecular characterisation of multi-drug resistant ST11 hypervirulent Klebsiella pneumoniae in a teaching hospital
Abstract
BACKGROUND: Infections caused by carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-HVKP) pose a critical challenge in clinical management due to limited treatment options and high mortality. Elucidating their virulence determinants and resistance mechanisms is essential for optimizing antimicrobial strategies and improving patient outcomes.
METHODS: We conducted a retrospective analysis of 102 carbapenem-resistant CRKP strains. Antimicrobial susceptibility testing was performed using the broth microdilution method, and resistance genotypes were characterized via PCR and Sanger sequencing. Virulence factors were identified through genomic sequencing and validated in a murine survival model (n = 6 mice per strain). Conjugation assays were performed to assess the transferability of resistance and virulence genes, with recipient strain E. coli J53, and transfer events were confirmed by PCR.
RESULTS: CRKP strains were predominantly derived from sputum-, urine- and blood-specimens. Patients with CRKP infections predominantly had pulmonary infections. CRKP exhibited high resistance to other β-lactam antibiotics, mainly due to the presence of blaKPC-2, high resistance to quinolones mediated by the carriage of aac (6''-Ib-cr), QnrS and QnrB, and high resistance to aminoglycosides mediated by the carriage of rmtB, ant(3'')-I and armA. CR-HVKP is mainly composed of ST11. Aerobactin (iucA, iutA), Ent siderophore (fepA, entB), Salmochelin (iroN), Yersiniabactin (ybtS), Type 3…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 6 participants or records.
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