Identification and Characterization of OXA-232-Producing Sequence Type 231 Multidrug Resistant Klebsiella pneumoniae Strains Causing Bloodstream Infections in China

Chen, Tao1; Xu, Hongyun2; Chen, Yunbo1; Ji, Jinru1; Ying, Chaoqun1; Liu, Zhiying1; Xu, Hao1; Zhou, Kai3; Xiao, Yonghong1,4; Shen, Ping1,4

2023-04-13

10.1128/spectrum.02607-22

MICROBIOLOGY SPECTRUM   Impact Factor & Quartile

2165-0497

["OXA-232 carbapenemase, being a vital resistance mechanism against carbapenems, has recently been increasingly reported. In China, the identified OXA-232-producing K. pneumoniae isolates almost belonged to ST15 and were not hypervirulent, despite harboring a virulence plasmid.","Klebsiella pneumoniae, a notorious pathogen for opportunistic health care-associated infections, represents increasing multidrug resistance, particularly to carbapenems. OXA-232 carbapenemase, as a variant of OXA-48, has been increasingly reported worldwide. ST231, an epidemic, multidrug resistant (MDR) K. pneumoniae clone in south and southeast Asia, has been found in other regions, including Europe. In the study, five OXA-232 carbapenemase-producing Klebsiella pneumoniae isolates, four of which belong to sequence type 231 (ST231) and one of which belongs to ST15, were isolated from two hospitals in China. All isolates displayed a MDR phenotype, being susceptible to only polymyxin B and colistin, and the bla(OXA-232) gene was located on a ColKP3-type nonconjugative plasmid of 6.1 kb. A phylogenetic analysis of the global ST231 K. pneumoniae isolates (n = 231) suggested that the four ST231 isolates from this study gathered with strains from south Asia (especially India), indicating that the emerging Chinese ST231 clone was more closely related to south Asia isolates and might have spread from south Asia, where ST231 was a successful epidemic clone. Virulence assays suggested that the four ST231 strains were not highly virulent, as they displayed significantly lower virulence potential, compared with a ST23 K1 hypervirulent isolate in a G. mellonella infection and in mouse intraperitoneal infection models, although three ST231 strains harbored a plasmid-borne aerobactin-encoding iuc gene cluster. This is the first report of ST231 K. pneumoniae clinical strains bearing bla(OXA-232) in China, and it highlights the emergence of the ST231 clone causing bloodstream infections in a health care setting as well as calls attention to the transmission of this emerging clone in China.IMPORTANCE OXA-232 carbapenemase, being a vital resistance mechanism against carbapenems, has recently been increasingly reported. In China, the identified OXA-232-producing K. pneumoniae isolates almost belonged to ST15 and were not hypervirulent, despite harboring a virulence plasmid. Here, we report the first occurrence in China of a MDR OXA-232-producing K. pneumoniae ST231 clone that is an epidemic ST type in south and southeast Asia. A phylogenetic analysis indicated that this emerging Chinese ST231 clone was more closely related to Indian isolates. The occurrence of this clone may have been driven through the transnational importation of Indian ST231 K. pneumoniae clones. Moreover, this study is the first to assess the virulence potential of ST231 clones that have never been estimated in previous studies. While the high burden of MDR K. pneumoniae is concerning, genomic surveillance can shed light on the transmission chains of novel MDR clones, and active surveillance should be enforced to restrict the spread of MDR isolates."]

OXA-232 multidrug resistant ST231 Klebsiella pneumoniae dissemination

SCI

English

Others

National Key Research and Development Program of China[2021YFC2300300] ; Key Research and Development Program of Zhejiang Province[2021C03068] ; Research Project of Jinan Microecological Biomedicine Shandong Laboratory["JNL-2022006B","JNL-2022027C"]

Microbiology

Microbiology

WOS:000954652300001

AMER SOC MICROBIOLOGY

Web of Science

1.Zhejiang Univ, Sch Med,State Key Lab Diag & Treatment Infect Dis, Affiliated Hosp 1,Natl Clin Res Ctr Infect Dis, Collaborat Innovat Ctr Diag & Treatment Infect Di, Hangzhou, Zhejiang, Peoples R China
2.Second Peoples Hosp Yunnan Prov, Dept Clin Lab, Kunming, Yunnan, Peoples R China
3.Southern Univ Sci & Technol, Shenzhen Peoples Hosp, Affiliated Hosp 1, Shenzhen, Guangdong, Peoples R China
4.Jinan Microecol Biomed Shandong Lab, Jinan, Shandong, Peoples R China

Chen, Tao,Xu, Hongyun,Chen, Yunbo,et al. Identification and Characterization of OXA-232-Producing Sequence Type 231 Multidrug Resistant Klebsiella pneumoniae Strains Causing Bloodstream Infections in China[J]. MICROBIOLOGY SPECTRUM,2023,11(2).

Chen, Tao.,Xu, Hongyun.,Chen, Yunbo.,Ji, Jinru.,Ying, Chaoqun.,...&Shen, Ping.(2023).Identification and Characterization of OXA-232-Producing Sequence Type 231 Multidrug Resistant Klebsiella pneumoniae Strains Causing Bloodstream Infections in China.MICROBIOLOGY SPECTRUM,11(2).

Chen, Tao,et al."Identification and Characterization of OXA-232-Producing Sequence Type 231 Multidrug Resistant Klebsiella pneumoniae Strains Causing Bloodstream Infections in China".MICROBIOLOGY SPECTRUM 11.2(2023).