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Separating Bacteria by Capsule Amount Using a Discontinuous Density Gradient
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Prevalence of hypervirulent and carbapenem-resistant Klebsiella pneumoniae under divergent evolutionary patterns

Dongxing Tian1, Xiao Liu2, Wenjie Chen3

  • 1Department of Clinical Laboratory, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.

Emerging Microbes & Infections
|July 18, 2022
PubMed

Insights

Hypervirulent carbapenem-resistant Klebsiella pneumoniae (hv-CRKP) are more prevalent in hospitals than carbapenem-resistant hvKP (CR-hvKp). Widespread conjugative carbapenem-resistance plasmids drive hv-CRKP emergence and hospital survival.

Area of Science:

  • Microbiology
  • Genetics
  • Epidemiology

Background:

  • Hypervirulent Klebsiella pneumoniae (hvKP) and carbapenem-resistant Klebsiella pneumoniae (CRKP) are significant clinical threats.
  • The emergence of hybrid strains, hv-CRKP and CR-hvKp, presents complex evolutionary pathways.
  • Understanding their prevalence and evolutionary drivers is crucial for infection control.

Purpose of the Study:

  • To investigate the prevalence of hv-CRKP and CR-hvKp strains.
  • To analyze the factors influencing the evolution and prevalence of these hybrid strains.
  • To compare the hospital suitability of hv-CRKP versus CR-hvKp.

Main Methods:

  • Genome analysis of 890 K. pneumoniae strains from GenBank.
  • Analysis of 530 clinical K. pneumoniae isolates from nine hospitals.
  • Investigation of plasmid mobilization mechanisms and genetic mutations (e.g., rfaH).

Main Results:

  • hv-CRKP strains were found to be more prevalent than CR-hvKp strains.
  • Both strain types were predominantly associated with the blaKPC-2 gene.
  • blaKPC-2-carrying plasmids facilitated the mobilization of virulence plasmids, with conserved oriT and conjugative helper plasmids playing key roles.
  • rfaH mutation in CR-hvKp strains reduced capsule synthesis and enhanced carbapenem resistance.

Conclusions:

  • hv-CRKP strains demonstrate greater suitability for survival in hospital settings compared to CR-hvKP strains.
  • The widespread dissemination of conjugative carbapenem-resistance plasmids is a major contributor to the emergence and prevalence of hv-CRKP.
  • Targeting plasmid-mediated resistance and virulence is essential for combating these pathogens.
Keywords:
Hypervirulentcarbapenem resistanceconjugationgenome evolutionoriT

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