Carbapenem-resistant Klebsiella pneumoniae ST11 Index from Single Strain Enduring Rapid Parallel Evolution during Persistent Infection. Klebsiella pneumoniae

In this report, we present a case of a patient enduring a challenging-to-treat Klebsiella pneumoniae infection persisting for two months. Nine K. pneumoniae isolates were collected and subjected to genome sequencing. Through a combination of comparative genomics, inference analysis of genesis dynamics, assessment of antibiotic susceptibility, observation of colony growth phenotype, and pathogenic testing, we identified this case as a multi-clonal infection initially dominated by ST101, followed by the emergence of hypervirulent and initially carbapenem-resistant ST11, both strains persisting for two months.