Characterization difference of typical KL1, KL2 and ST11-KL64 hypervirulent and carbapenem-resistant Klebsiella pneumoniae. (March 2023)

• Record Type: Journal Article
• Authors: Zhou, Ying; Wu, Chunyang; Wang, Bingjie; Xu, YanLei; Zhao, Huilin; Guo, Yinjuan; Wu, Xiaocui; Yu, Jingyi; Rao, Lulin; Wang, Xinyi; Yu, Fangyou
• Is Part Of: Drug resistance updates. Volume 67(2023)
• Publication Date: 2023-03
• Subjects: Klebsiella pneumoniae -- KPC-2 -- Virulence plasmid -- Carbapenem resistance -- Hypervirulence; Drug resistance in cancer cells -- Periodicals; Cancer -- Chemotherapy -- Periodicals; 616.994061
• DOI: 10.1016/j.drup.2023.100918
• Languages: English
• ISSNs: 1368-7646

Abstract

Abstract: Almost all the formation of hypervirulent and carbapenem-resistant Klebsiella pneumoniae follow two major patterns: KL1/KL2 hvKP strains acquire carbapenem-resistance plasmids (CR-hvKP), and carbapenem-resistant Klebsiella pneumoniae (CRKP) strains obtain virulence plasmids (hv-CRKP). These two patterns may pose different phenotypes. In this study, three typical resistance and hypervirulent K. pneumoniae (KL1, KL2, and ST11-KL64), isolating from poor prognosis patients, were selected. Compared with ST11-KL64 hv-CRKP, KL1/KL2 hypervirulent lineages harbor significantly fewer resistance determinants and exhibited lower-level resistance to antibiotics. Notably, though the bla KPC gene could be detected in all these isolates, KL1/KL2 hvKP strain did not exhibit corresponding high-level carbapenem resistance. Unlike the resistance features, we did not observe significant virulence differences between the three strains. The ST11-KL64 hv-CRKP (1403) in this study, showed similar mucoviscosity, siderophores production, and biofilm production compared with KL1 and KL2 hvKP. Moreover, the hypervirulent of ST11-KL64 hvKP also verified with the human lung epithelial cells infection and G. mellonella infection models. Moreover, we found the pLVPK-like virulence plasmid and IncF bla KPC-2 plasmid was crucial for the formation of hypervirulent and carbapenem-resistant K. pneumoniae . The conservation of origin of transfer site ( oriT ) in these virulence and bla KPC-2 plasmids, indicated the virulence plasmids could transfer to CRKP with the help of bla KPC-2 plasmids. The co-existence of virulence plasmid and bla KPC-2 plasmid facilitate the formation of ST11-KL64 hv-CPKP, which then become nosocomial epidemic under the antibiotic stress. The ST11-KL64 hv-CPKP may poses a substantial threat to healthcare networks, urgent measures were needed to prevent further dissemination in nosocomial settings.