中国高风险耐碳青霉烯类肺炎克雷伯氏菌亚克隆的扩展和传播动态:流行病学、空间和基因组分析

IF 15.8 1区 医学 Q1 PHARMACOLOGY & PHARMACY Drug Resistance Updates Pub Date : 2024-03-29 DOI:10.1016/j.drup.2024.101083
Qi Wang , Ruobing Wang , Shuyi Wang , Anru Zhang , Qiaoyan Duan , Shijun Sun , Longyang Jin , Xiaojuan Wang , Yawei Zhang , Chunlei Wang , Haiquan Kang , Zhijie Zhang , Kang Liao , Yinghui Guo , Liang Jin , Zhiwu Liu , Chunxia Yang , Hui Wang , on behalf of the China Carbapenem-Resistant Enterobacterales (CRE) Network
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引用次数: 0

摘要

目的耐碳青霉烯类肺炎克雷伯氏菌(CRKP)是一种全球性威胁,因地区而异。我们利用 2011 年至 2021 年期间从中国 28 个省市获得的分离株开展了一项多中心分子流行病学调查。结果在 ST11 CRKP 中,KL64 血清型表现出相当大的扩展性,从 2011 年的 1.54% 增加到 2021 年的 46.08%。结合我们的数据和公共数据库,系统发生学和系统地理学分析表明,ST11 CRKP于1996年出现在美洲,并向全球扩散,到2010年,主要克隆从中国东南沿海向内陆扩散。全球系统进化分析表明,ST11 KL64 CRKP 已经进化为一个具有明显区域性传播的毒性、抗性支系。单核苷酸多态性(SNP)分析发现,BMPPS(bmr3、mltC、PYRB、ppsC 和 sdaC)是该支系的关键标记。结论 高风险 ST11 KL64 CRKP 亚克隆显示出很强的扩增潜力和生存优势,这可能是遗传因素造成的。
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Expansion and transmission dynamics of high risk carbapenem-resistant Klebsiella pneumoniae subclones in China: An epidemiological, spatial, genomic analysis

Aims

Carbapenem-resistant Klebsiella pneumonia (CRKP) is a global threat that varies by region. The global distribution, evolution, and clinical implications of the ST11 CRKP clone remain obscure.

Methods

We conducted a multicenter molecular epidemiological survey using isolates obtained from 28 provinces and municipalities across China between 2011 and 2021. We integrated sequences from public databases and performed genetic epidemiology analysis of ST11 CRKP.

Results

Among ST11 CRKP, KL64 serotypes exhibited considerable expansion, increasing from 1.54% to 46.08% between 2011 and 2021. Combining our data with public databases, the phylogenetic and phylogeography analyses indicated that ST11 CRKP appeared in the Americas in 1996 and spread worldwide, with key clones progressing from China’s southeastern coast to the inland by 2010. Global phylogenetic analysis showed that ST11 KL64 CRKP has evolved to a virulent, resistant clade with notable regional spread. Single-nucleotide polymorphism (SNP) analysis identified BMPPS (bmr3, mltC, pyrB, ppsC, and sdaC) as a key marker for this clade. The BMPPS SNP clade is associated with high mortality and has strong anti-phagocytic and competitive traits in vitro.

Conclusions

The high-risk ST11 KL64 CRKP subclone showed strong expansion potential and survival advantages, probably owing to genetic factors.

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来源期刊
Drug Resistance Updates
Drug Resistance Updates 医学-药学
CiteScore
26.20
自引率
11.90%
发文量
32
审稿时长
29 days
期刊介绍: Drug Resistance Updates serves as a platform for publishing original research, commentary, and expert reviews on significant advancements in drug resistance related to infectious diseases and cancer. It encompasses diverse disciplines such as molecular biology, biochemistry, cell biology, pharmacology, microbiology, preclinical therapeutics, oncology, and clinical medicine. The journal addresses both basic research and clinical aspects of drug resistance, providing insights into novel drugs and strategies to overcome resistance. Original research articles are welcomed, and review articles are authored by leaders in the field by invitation. Articles are written by leaders in the field, in response to an invitation from the Editors, and are peer-reviewed prior to publication. Articles are clear, readable, and up-to-date, suitable for a multidisciplinary readership and include schematic diagrams and other illustrations conveying the major points of the article. The goal is to highlight recent areas of growth and put them in perspective. *Expert reviews in clinical and basic drug resistance research in oncology and infectious disease *Describes emerging technologies and therapies, particularly those that overcome drug resistance *Emphasises common themes in microbial and cancer research
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