Regional surveillance of carbapenem-resistant Klebsiella pneumoniae responsible for bloodstream infections in Hebei province

Abstract

Objective To investigate the epidemiological characteristics of CRKP responsible for BSIs in Hebei Province, China. Methods A total of 100 CRKP isolates were obtained across 15 hospitals in eight cities in Hebei Province, China, between 2022 and 2024. Polymerase chain reaction and short-read whole-genome sequencing were used to characterize the molecular profiles of the strains. Results All isolates exhibited high-level resistance to β-lactam antibiotics, including a 100% resistance rate to carbapenems and resistance rates of > 97% to β-lactamase inhibitor combinations. The blaKPC was the predominant carbapenemase gene (89%, 89/100). In this study, 62 carbapenem-resistant Klebsiella pneumoniae isolates harboring multiple hypervirulence-related genes (CR-hvKp) and 38 carbapenem-resistant classical Klebsiella pneumoniae (CR-cKp) isolates were identified. The predominant plasmid replicon types were IncFII(pHN7A8) (69%, 69/100) and ColRNAI (71%, 71/100). Notably, according to the core-genome SNP analysis, the ST11-KL64 subclone was the predominant lineage among the sampled isolates (48%, 48/100). Conclusions The CRKP isolates from BSIs exhibit significant drug resistance and high virulence characteristics, warranting widespread clinical attention.