Antimicrobial resistance and molecular characteristics of Klebsiella pneu-moniae in intensive care unit environment based on whole genome sequencing
10.12138/j.issn.1671-9638.20257358
- VernacularTitle:基于全基因组测序的ICU环境中肺炎克雷伯菌耐药及分子特征分析
- Author:
Bowen YANG
1
;
Yuanping WANG
;
Yiying XU
;
Wenqing WANG
;
Tongsheng XU
;
Lingyue YUAN
;
Bing ZHAO
;
Xiao WANG
Author Information
1. 上海市浦东新区疾病预防控制中心微检室,上海 200136
- Publication Type:Journal Article
- Keywords:
ICU environment;
Klebsiella pneumoniae;
whole genome sequencing;
drug resistance phenotype;
genotype
- From:
Chinese Journal of Infection Control
2025;24(9):1229-1236
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the distribution characteristics of Klebsiella pneumoniae(KP),hyperviru-lent Klebsiella pneumoniae(hvKP),carbapenem-resistant Klebsiella pneumoniae(CRKP),and hypervirulent car-bapenem-resistant Klebsiella pneumoniae(hv-CRKP/CR-hvKP)in the environment of general intensive care unit(ICU)at medical institutions,and provide reference for environment assessment as well as healthcare-associated in-fection(HAI)prevention and control in ICU.Methods A total of 3 336 environmental specimens were collected from general ICUs of medical institutions in Shanghai in 2019 and 2023.After strain isolation,antimicrobial suscep-tibility testing and whole genome sequencing were conducted.Results The detection rate of KP was 1.59%(n=53),among which hvKP,CRKP,and hv-CRKP/CR-hvKP accounted for 37.74%(20/53),52.83%(28/53),and 24.53%(13/53)of the total detected strains,respectively.The main types of hvKP were ST11-KL64 and ST11-KL25,CRKP were ST15-KL19 and ST11-KL25,hv-CRKP/CR-hvKP were ST11-KL25 and ST11-KL64.The main carried resistance genes included fosA,oqx AB,tet(A),blaTEM-1B,blaKPC-2,qnrS11,etc.All strains carried viru-lence genes fimH,iutA,ent A,entB,entC,entD,entE,and entF,with only one strain carrying rmp A gene.Conclusion KP contamination is widespread in general ICU environment of medical institutions,predominantly ST11 and ST15,presenting a polymorphic distribution.CRKP and hvKP account for a relatively high proportion,and multidrug resistance is serious.Co-evolution of drug resistance and virulence presents in KP,and poses signifi-cant infection and pathogenic risks to patients,necessitating enhanced clinical vigilance and preparedness for poten-tial outbreaks.