Raw data-Molecular epidemiology of carbapenem-resistant hypervirulent Klebsiella pneumoniae Risk factors and resistance mechanism of ceftazidimeavibactam in China.xlsx

The high morbidity and mortality rates associated with carbapenem-resistant hypervirulent Klebsiella pneumoniae(CR-hvKP) have become a global public health problem. This study explored the optimal concentration of a novel β-lactam/inhibitor and the resistance mechanism of ceftazidime/avibactam of CR-hvKP. We analyzed the whole genome sequence and epidemiological data of 81 carbapenem-resistant Klebsiella pneumoniae(KP) strains and conducted sensitivity experiments to explore the optimal concentration of carbapenem-resistant Klebsiella pneumoniae(CRKP).We verified the resistance and virulence genes of CRKP using polymerase chain reaction and compared virulence between CRKP and carbapenem-resistant-non-hypervirulent Klebsiella pneumoniae(CR-non-hvKP) through Galleria mellonella assays. The prevalent types of multilocus sequence typing in our CRKP strains were ST11 (69.14%, 56/81). ST11-K64-O1/O2v1 has become an epidemic type in our hospital, with drug-resistance genes dominated by blaKPC-2 (90.12%, 73/81). Ceftazidime/avibactam has better antibacterial effects on CRKP, and its resistance is mainly mediated by a resistance plasmid containing the blaKPC-2 gene. 52 CR-hvKP strains carry the blaKPC-2, with a high detection rate of siderophore. Further research has shown that the genetic environment of the blaKPC-2 contains TnpR_Tn3 and ISKpn27 upstream and ISKpn6 insertion sequences downstream. Galleria mellonella revealed that the survival rate of CR-hvKP was lower than that of CR-non-hvKP. Antibiotic usage time, Carbapenem antibiotic exposure, and Malignant tumors were independent risk factors for CR-hvKP infection. The spread of CR-hvKP strains is alarming, necessitating molecular monitoring of hypervirulent strains and strengthening the nosocomial infection prevention and control measures. Antibiotics should be used reasonably based on patients' infection status and local epidemiological data.