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Background <p>Carbapenem-resistant hypervirulent&#xa0;<i>Klebsiella pneumoniae&#xa0;</i>(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.</p> Methods <p>A genomic analysis of 2,002&#xa0;<i>Klebsiella pneumoniae&#xa0;</i>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.</p> Results <p>A total of 127 CR-HvKp were characterized, with ST11-KL64 hv-CRKP (carbapenem resistant&#xa0;<i>Klebsiella pneumoniae&#xa0;</i>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 (<i>P </i>&lt; 0.0001).</p> Conclusion <p>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.</p>

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Nosocomial transmission, adaption and clinical outcomes of carbapenem-resistant hypervirulent Klebsiella pneumoniae

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月2日

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  • Yanjun Liu,
  • Zhiqian Wang,
  • Zijuan Jian,
  • Peilin Liu,
  • Yanming Li,
  • Fang Qin,
  • Qun Yan,
  • Wenen Liu

摘要

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.