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Study on the correlation between carbapenem-resistant Klebsiella pneumoniae infection strains and intestinal colonization strains in intensive care unit of a tertiary hospital in China

  • 0Department of Laboratory Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China.
Journal of Global Antimicrobial Resistance +

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May 21, 2025

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May 21, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Carbapenem-resistant Klebsiella pneumoniae (CRKP) intestinal colonization in ICU patients frequently leads to infection. Genomic analysis suggests CRKP infections often arise from existing colonization, with potential acquisition of new resistance genes.

Area Of Science

  • Infectious Diseases
  • Microbiology
  • Genomics

Background

  • Colonization by carbapenem-resistant Klebsiella pneumoniae (CRKP) is a significant risk factor for developing CRKP infections.
  • The precise relationship between CRKP colonization and subsequent infection remains incompletely understood.

Purpose Of The Study

  • To investigate the clonal relationship between CRKP colonization and infection in intensive care unit (ICU) patients.
  • To identify the genetic characteristics of CRKP strains involved in colonization and infection.

Main Methods

  • Prospective cohort study of ICU patients screened for rectal CRKP colonization.
  • Isolates underwent antibiotic susceptibility testing, modified carbapenem inactivation method, serum bactericidal/phagocytic assays, and whole genome sequencing.
  • Comparison of colonization and infection site isolates from 7 CRKP-colonized patients who developed infection.

Main Results

  • Of 82 colonized ICU patients, 41 (50%) developed CRKP infections.
  • Whole genome sequencing of 14 CRKP strains (from 7 patients) revealed blaKPC-2 production and conserved genetic environments.
  • Colonized and infected strains from the same patient shared identical virulence genes, with <10 single nucleotide polymorphism differences, suggesting a common origin.
  • Differences in resistance genes and plasmids were observed between colonized and infected strains within patients.

Conclusions

  • Preventing intestinal CRKP colonization in hospitalized patients is crucial for reducing nosocomial infections.
  • Genomic similarities indicate that CRKP infections likely originate from antecedent colonization, with possible acquisition of resistance determinants during transformation.
  • The blaKPC-2-carrying K. pneumoniae ST5422, closely related to ST11, is reported for the first time.

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