Nosocomial transmission, adaption and clinical outcomes of carbapenem-resistant hypervirulent Klebsiella pneumoniae
Abstract Background Carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-HvKp) poses a significant threat in healthcare settings. This study investigates the nosocomial transmission dynamics, adaptive phenotypes, and clinical outcomes of CR-HvKp with different evolutionary patterns. Methods...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-07-01
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| Series: | BMC Microbiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12866-025-04096-z |
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| Summary: | Abstract Background Carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-HvKp) poses a significant threat in healthcare settings. This study investigates the nosocomial transmission dynamics, adaptive phenotypes, and clinical outcomes of CR-HvKp with different evolutionary patterns. Methods A genomic analysis of 2,002 Klebsiella pneumoniae isolates collected from a major teaching hospital in China was performed to identify convergent isolates. Epidemiological features, including CR-HvKp nosocomial transmission, were assessed. Selected isolates underwent phenotypic testing to evaluate adaptive traits. Clinical outcomes were analyzed retrospectively using electronic medical records. Results A total of 127 CR-HvKp were characterized, with ST11-KL64 hv-CRKP (carbapenem resistant Klebsiella pneumoniae acquired hypervirulence) as the predominant sequence type. CR-HvKp exhibited diverse evolutionary patterns linked to nosocomial transmission, particularly in the ICU. ST11-KL64 hv-CRKP demonstrated robust transmission within ICU settings. Compared to CRKP, hv-CRKP showed enhanced in vitro competitiveness and superior immune evasion. CR-HvKp infections were significantly associated with higher mortality rates, especially involved in sepsis or septic shock (P < 0.0001). Conclusion The ST11-KL64 hv-CRKP clonal complex is highly prevalent in CR-HvKp and demonstrates significant nosocomial transmission, particularly within ICU settings. Timely and effective sepsis management is critical to improving survival outcomes in CR-HvKp infections. Continuous genomic surveillance is imperative to control the spread of these pathogens. |
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| ISSN: | 1471-2180 |