Molecular Typing and Drug Resistance Analysis of Carbapenem-resistant Klebsiella Pneumoniae from ICU Patients in China

Abstract

Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) stands out as one of the most detrimental nosocomial pathogens in Chinese hospitals. The resistance rate of CRKP to carbapenems has persistently remained elevated, particularly in intensive care unit (ICU). This study focused on the molecular epidemiological characteristics of CRKP isolated from Chinese ICU patients. Materials and Methods: Five distinct CRKP isolates were obtained from a Chinese hospital. Strain identification and drug susceptibility testing were conducted using the VITEK® 2 Compact Bacterial Identification and Monitoring System. Whole genome sequencing (WGS) technology was used to analyze sequence typing, phylogenetic relationships and drug resistance genes. Results: All five CRKP isolates carried the carbapenem-resistance gene blaKPC-2 and exhibited complete resistance to β-lactams, aminoglycosides, quinolones, and partial resistance to sulfonamides. Based on the single nucleotide polymorphism differences, we classified the five CRKP isolates into 3 distinct clusters. Multilocus sequence typing (MLST) and core genome multilocus sequence typing (cgMLST) identified the main prevalent sequence type of CRKP as ST11-CT1313. Conclusions: Utilizing WGS for sequence typing, phylogenetic analysis, and antibiotic resistance gene identification is essential in enhancing the control and containment of CRKP infections in ICU. However, it is vital to consider both resistance phenotypes and resistance genes when guiding clinical medication decisions.