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Tracking international and regional dissemination of the KPC/NDM co-producing Klebsiella pneumoniae

Author

Listed:
  • Feilong Zhang

    (Chinese Academy of Medical Sciences
    Chinese Academy of Medical Sciences)

  • Xinmeng Liu

    (Chinese Academy of Medical Sciences)

  • Ziyao Li

    (Chinese Academy of Medical Sciences)

  • Zhihua Li

    (Chinese Academy of Medical Sciences
    Peking University China-Japan Friendship School of Clinical Medicine)

  • Zichen Lei

    (Chinese Academy of Medical Sciences
    China-Japan Friendship Institute of Clinical Medical Sciences)

  • Yanyan Fan

    (Chinese Academy of Medical Sciences)

  • Xinrui Yang

    (Chinese Academy of Medical Sciences
    Chinese Academy of Medical Sciences)

  • Qi Liu

    (Chinese Academy of Medical Sciences
    China-Japan Friendship Institute of Clinical Medical Sciences)

  • Yiqun Ma

    (Chinese Academy of Medical Sciences
    Peking University China-Japan Friendship School of Clinical Medicine)

  • Binghuai Lu

    (Chinese Academy of Medical Sciences
    Chinese Academy of Medical Sciences
    Peking University China-Japan Friendship School of Clinical Medicine
    China-Japan Friendship Institute of Clinical Medical Sciences)

Abstract

KPC and NDM co-producing carbapenem-resistant Klebsiella pneumoniae (KN-CRKP) showed an upward trend; nevertheless, global systematic and comprehensive analyses profiling remain lacking. 968 local CRKP were collected from 6 provinces in China, and 64,354 genomes were retrieved from GenBank. All 413 genomes of KN-CRKP were obtained from 32 countries, including 16 subtypes of KN-CRKP. The top three CRKP subtypes, K2N1-CRKP, K2N5-CRKP and K3N1-CRKP, exhibited distinct geographic distributions, with K2N1-CRKP and K2N5-CRKP primarily circulating in China while K3N1-CRKP showed predominant prevalence in USA. Meanwhile, ST11-KL64, ST11-KL47, and ST258-KL107, were the three most prevalent ST and KL, and 64.3% of ST11-KL64 KN-CRKP belonged to hypervirulent strains. Genomes revealed Clone Group 1, accounting for 55.0% of KN-CRKP, shifting from KL47 to KL64 and carrying more hypervirulence genes, has a significant advantage in adhesion, invasion, and proliferation, and its dispersal was the primary driver contributing to the worldwide spread of KN-CRKP. Furthermore, ST11 KN-CRKP was generally formed by KPC-producing CRKP acquiring blaNDM-carrying plasmid and novel hybrid plasmids co-encoding KPC and NDM have occurred. Aztreonam/avibactam and cefiderocol were promising antimicrobial agents against KN-CRKP. The global KN-CRKP research, spanning from 2005 to 2024, provides valuable insights into the global transmission, dynamics, and treatment of KN-CRKP.

Suggested Citation

  • Feilong Zhang & Xinmeng Liu & Ziyao Li & Zhihua Li & Zichen Lei & Yanyan Fan & Xinrui Yang & Qi Liu & Yiqun Ma & Binghuai Lu, 2025. "Tracking international and regional dissemination of the KPC/NDM co-producing Klebsiella pneumoniae," Nature Communications, Nature, vol. 16(1), pages 1-13, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-60765-7
    DOI: 10.1038/s41467-025-60765-7
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    References listed on IDEAS

    as
    1. Kai Zhou & Chun-Xu Xue & Tingting Xu & Ping Shen & Sha Wei & Kelly L. Wyres & Margaret M. C. Lam & Jinquan Liu & Haoyun Lin & Yunbo Chen & Kathryn E. Holt & Yonghong Xiao, 2023. "A point mutation in recC associated with subclonal replacement of carbapenem-resistant Klebsiella pneumoniae ST11 in China," Nature Communications, Nature, vol. 14(1), pages 1-14, December.
    2. repec:plo:pcbi00:1003537 is not listed on IDEAS
    3. Mislav Acman & Ruobing Wang & Lucy Dorp & Liam P. Shaw & Qi Wang & Nina Luhmann & Yuyao Yin & Shijun Sun & Hongbin Chen & Hui Wang & Francois Balloux, 2022. "Role of mobile genetic elements in the global dissemination of the carbapenem resistance gene blaNDM," Nature Communications, Nature, vol. 13(1), pages 1-13, December.
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