Emergence and regional spread of extended-spectrum β-lactamase-producing Klebsiella pneumoniae ST307 at a Japanese tertiary-care hospital
Abstract
The global emergence of extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-Kp), especially antimicrobial-resistant high-risk clones, is a public health concern. However, data on their molecular epidemiology in Japan remain limited. In this study, we conducted molecular analysis of 119 ESBL-Kp clinical isolates collected between January 2020 and April 2023 at a Japanese tertiary-care hospital. We identified 42 sequence types (STs), of which the most common was ST307 (n = 60, 50.4%), an antimicrobial-resistant high-risk clone. All ST307 isolates carried CTX-M-15, and 53 (88%) co-harbored OXA-1. Of the 60 ST307 isolates, 54 (90%) transferred IncFIIK plasmids carrying CTX-M-15 to Escherichia coli J53 recipients in conjugation experiments. ST307 isolates showed higher resistance rates than non-ST307 isolates, particularly to levofloxacin (100% vs 19%). Whole-genome sequencing of nine ST307 isolates revealed that blaCTX-M-15, blaOXA-1, and other antimicrobial-resistance genes were located on the same plasmid. All nine isolates had the GyrA S83I and ParC S80I substitutions. ST307 was found in both inpatients and outpatients, and core-SNP analysis revealed a narrow distance between inpatient and outpatient isolates, suggesting regional spread.IMPORTANCESequence type (ST) 307 is an emerging antimicrobial-resistant high-risk clone of Klebsiella pneumoniae with global clinical relevance. This study is the first to document large-scale dissemination of ST307 in Japan,…
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