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 <i>Klebsiella pneumoniae</i>(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 <i>Klebsiella pneumoniae</i>(<i>KP</i>) strains and conducted sensitivity experiments to explore the optimal concentration of carbapenem-resistant <i>Klebsiella pneumoniae</i>(CRKP).We verified the resistance and virulence genes of CRKP<i> </i>using polymerase chain reaction and compared virulence between CRKP and carbapenem-resistant-non-hypervirulent <i>Klebsiella pneumoniae</i>(CR-non-hvKP) through <i>Galleria mellonella</i> assays. The prevalent types of multilocus sequence typing in our CRKP<i> </i>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 bla_KPC-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 bla_KPC-2 gene. 52 CR-hvKP strains carry the bla_KPC-2, with a high detection rate of siderophore. Further research has shown that the genetic environment of the bla_KPC-2 contains TnpR_Tn3 and ISKpn27 upstream and ISKpn6 insertion sequences downstream. <i>Galleria mellonella</i> 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.