Supplementary materials for "Antimicrobial resistance and plasmidome of carbapenemase-resistant Klebsiella pneumoniae causing bloodstream infections between 2014 and 2024"

The WHO has designated carbapenemase-resistant Klebsiella pneumoniae (CRKP) as a priority pathogen due to the potential for nosocomial infection outbreaks. In this study, a total of 724 non-duplicated K. pneumoniae bloodstream infection isolates were collected in Beijing between 2014 and 2024, of which 14.5% were identified as CRKP. The incidence of CRKP isolates remained at a relatively high level since 2018, with a significant increase observed following the SARS-CoV-2 epidemic. The most common sequence type was ST11 (84.8%), followed by ST16 (5.7%) and ST15 (5.7%). Sixteen potential clonal transmissions were identified, including four clonal clusters transmitted at the ward-level. Antimicrobial resistance was severe, with almost all isolates showing resistance to 15 antimicrobials tested. The blaKPC-2 (93.3%) was the dominated carbapenemase genes, followed by blaOXA-181 (5.7%). The blaCTX-M-65 (13/105) was the most common ESBL gene, followed by blaCTX-M-15 (15/105) and blaSHV-12 (64/105). Phenotype-genotype concordance was 100% for cephalosporins and carbapenemases. The correlation of plasmids with AMR and virulence genes were determined, with the IncFII(pHN7A8)_1_pHN7A8 plasmid showing a significant correlation with blaCTX-M-65 and blaKPC-2, and the IncHI1B_1_pNDM-MAR and IncR_1 plasmids significantly correlated with iucABC-iutA (P