上海部分地区医院感染和社区获得性感染耐碳青霉烯类肺炎克雷伯菌耐药及基因组分析OA

From June to December 2024,99 carbapenem-resistant Klebsiella pneumoniae(CRKP)isolates were collected in Shanghai,including both hospital-acquired and community-acquired strains.Antimicrobial susceptibility was determined by broth mi-crodilution,and whole-genome sequencing together with Kleborate was used to delineate multilocus sequence types,capsular sero-types,resistance/virulence genes,and plasmid replicons.A whole-genome SNP phylogeny was also constructed.All isolates were sus-ceptible to tigecycline and resistant to ampicillin.The colistin resistance rate in hospital-acquired CRKP(19.05%)was higher than that in community-acquired CRKP(3.51%,P<0.05),whereas no differences were observed for other agents.KPC-2 accounted for 91.57%of the carbapenemase genes,and β-lactamase/aminoglycoside resistance genes were detected in 89.90%of isolates.The siderophore-related virulence genes ybtT and iucA were carried by 88.88%and 76.77%of strains,respectively,and no statistical differ-ence was observed between groups.Sixteen STs were identified,among which ST11-KL25 and ST11-KL64 predominated.Twenty-four plasmid replicons belonging to seven incompatibility groups were found,and IncF types were present in 97.98%of isolates.The phylogenetic tree revealed four clades in which hospital and community strains were intermingled,and no significant differences in ST,serotype,or plasmid profile were observed.These findings indicated that local CRKP was represented primarily by ST11-KL64/25 and ST859-KL19 clones bearing KPC-2 and IncF plasmids.The only notable distinction was the elevated colistin resistance rate among hospital isolates,thus underscoring the need for an integrated hospital-community surveillance and intervention network to achieve syn-ergistic control of CRKP infections.