Virulence evolution, molecular mechanisms of resistance and prevalence of ST11 carbapenem-resistant Klebsiella pneumoniae in China: A review over the last 10 years. (December 2020)

• Record Type: Journal Article
• Authors: Liao, Wenjian; Liu, Yang; Zhang, Wei
• Is Part Of: Journal of global antimicrobial resistance. Volume 23(2020)
• Page Start: 174
• Page End: 180
• Publication Date: 2020-12
• Subjects: Virulence evolution -- ST11 -- Carbapenem-resistant Klebsiella pneumoniae -- Resistance mechanism -- Phylogenetic analysis; Drug resistance -- Periodicals; Drug resistance -- Periodicals; Drug resistance; Periodicals; 616.9041
• DOI: 10.1016/j.jgar.2020.09.004
• Languages: English
• ISSNs: 2213-7165

Abstract

Highlights: ST11 is the dominant clone of carbapenem-resistant K. pneumoniae in China at an alarming speed. ST11 CRKP almost can be resistant to all the common clinically used antibiotics such as carbapenems, broad-spectrum β-lactams, quinolones, aminoglycosides, fosfomycin, trimethoprim, tigecycline, colistin, and even ceftazidime/avibactam. There is a very close linkage among IncF plasmids, NTEKPC, and ST11 Klebsiella pneumoniae in China. The recent emergence of ST11 CR-hvKP strains in China attracts worldwide attention by acquiring a pLVPK-like virulence plasmid because such strains may cause severe infection in relatively healthy individuals that difficult to treat with current antibiotics. Abstract: Sequence type 11 (ST11) carbapenem-resistant Klebsiella pneumoniae (CRKP) has become the dominant clone in China. In this review, we trace the prevalence of ST11 CRKP in the China Antimicrobial Surveillance Network (CHINET), the key antimicrobial resistance mechanisms and virulence evolution. The recent emergence of ST11 carbapenem-resistant hypervirulent K. pneumoniae (CR-hvKP) strains in China due to the acquisition of a pLVPK-like virulence plasmid, which may cause severe infections in relatively healthy individuals that are difficult to treat with current antibiotics, has attracted worldwide attention. There is a very close linkage among IncF plasmids, NTEKPC and ST11 K. pneumoniae in China. Hybrid conjugative virulence plasmids are demonstrated to readily convert a ST11 CRKP strain to a CR-hvKP strain via conjugation. Understanding the molecular evolutionary mechanisms of resistance and virulence-bearing plasmids as well as the prevalence of ST11 CRKP in China allows improved tracking and control of such organisms.