Characterization difference of typical KL1, KL2 and ST11-KL64 hypervirulent and carbapenem-resistant Klebsiella pneumoniae

Ying Zhou; Chunyang Wu; Bingjie Wang; YanLei Xu; Huilin Zhao; Yinjuan Guo; Xiaocui Wu; Jingyi Yu; Lulin Rao; Xinyi Wang; Fangyou Yu

doi:10.1016/j.drup.2023.100918

Characterization difference of typical KL1, KL2 and ST11-KL64 hypervirulent and carbapenem-resistant Klebsiella pneumoniae

Drug Resist Updat. 2023 Mar:67:100918. doi: 10.1016/j.drup.2023.100918. Epub 2023 Jan 3.

Authors

Ying Zhou¹, Chunyang Wu², Bingjie Wang¹, YanLei Xu¹, Huilin Zhao¹, Yinjuan Guo¹, Xiaocui Wu¹, Jingyi Yu¹, Lulin Rao¹, Xinyi Wang¹, Fangyou Yu³

Affiliations

¹ Department of Clinical Laboratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200082, People's Republic of China.
² Department of Respiratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, People's Republic of China.
³ Department of Clinical Laboratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200082, People's Republic of China; Department of Laboratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China. Electronic address: wzjxyfy@163.com.

PMID: 36610180
DOI: 10.1016/j.drup.2023.100918

Abstract

Almost all the formation of hypervirulent and carbapenem-resistant Klebsiella pneumoniae follow two major patterns: KL1/KL2 hvKP strains acquire carbapenem-resistance plasmids (CR-hvKP), and carbapenem-resistant Klebsiella pneumoniae (CRKP) strains obtain virulence plasmids (hv-CRKP). These two patterns may pose different phenotypes. In this study, three typical resistance and hypervirulent K. pneumoniae (KL1, KL2, and ST11-KL64), isolating from poor prognosis patients, were selected. Compared with ST11-KL64 hv-CRKP, KL1/KL2 hypervirulent lineages harbor significantly fewer resistance determinants and exhibited lower-level resistance to antibiotics. Notably, though the bla_KPC gene could be detected in all these isolates, KL1/KL2 hvKP strain did not exhibit corresponding high-level carbapenem resistance. Unlike the resistance features, we did not observe significant virulence differences between the three strains. The ST11-KL64 hv-CRKP (1403) in this study, showed similar mucoviscosity, siderophores production, and biofilm production compared with KL1 and KL2 hvKP. Moreover, the hypervirulent of ST11-KL64 hvKP also verified with the human lung epithelial cells infection and G. mellonella infection models. Moreover, we found the pLVPK-like virulence plasmid and IncF bla_KPC-2 plasmid was crucial for the formation of hypervirulent and carbapenem-resistant K. pneumoniae. The conservation of origin of transfer site (oriT) in these virulence and bla_KPC-2 plasmids, indicated the virulence plasmids could transfer to CRKP with the help of bla_KPC-2 plasmids. The co-existence of virulence plasmid and bla_KPC-2 plasmid facilitate the formation of ST11-KL64 hv-CPKP, which then become nosocomial epidemic under the antibiotic stress. The ST11-KL64 hv-CPKP may poses a substantial threat to healthcare networks, urgent measures were needed to prevent further dissemination in nosocomial settings.

Keywords: Carbapenem resistance; Hypervirulence; KPC-2; Klebsiella pneumoniae; Virulence plasmid.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anti-Bacterial Agents / pharmacology
Anti-Bacterial Agents / therapeutic use
Carbapenem-Resistant Enterobacteriaceae* / genetics
Carbapenems / pharmacology
Carbapenems / therapeutic use
Cross Infection*
Humans
Klebsiella Infections* / drug therapy
Klebsiella Infections* / epidemiology
Klebsiella pneumoniae / genetics
beta-Lactamases / genetics

Substances

Anti-Bacterial Agents
Carbapenems
beta-Lactamases