# Molecular Typing and Drug Resistance Analysis of Carbapenem-resistant Klebsiella Pneumoniae from ICU Patients in China

## TL;DR

This study analyzes CRKP bacteria from ICU patients in China to understand their genetic makeup and drug resistance patterns.

## Contribution

The study identifies the prevalent sequence type ST11-CT1313 and resistance gene blaKPC-2 in CRKP isolates from Chinese ICUs.

## Key findings

- All five CRKP isolates carried the resistance gene blaKPC-2 and showed resistance to multiple antibiotic classes.
- Genomic analysis grouped the isolates into three distinct clusters based on SNP differences.
- MLST and cgMLST identified ST11-CT1313 as the main prevalent sequence type.

## Abstract

Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) stands out as one
of the most detrimental nosocomial pathogens in Chinese hospitals. The
resistance rate of CRKP to carbapenems has persistently remained elevated,
particularly in intensive care unit (ICU). This study focused on the molecular
epidemiological characteristics of CRKP isolated from Chinese ICU
patients.Materials and Methods: Five distinct CRKP isolates were obtained from a
Chinese hospital. Strain identification and drug susceptibility testing were
conducted using the VITEK® 2 Compact Bacterial Identification and Monitoring
System. Whole genome sequencing (WGS) technology was used to analyze sequence
typing, phylogenetic relationships and drug resistance genes.Results: All five
CRKP isolates carried the carbapenem-resistance gene blaKPC-2 and exhibited
complete resistance to β-lactams, aminoglycosides, quinolones, and partial
resistance to sulfonamides. Based on the single nucleotide polymorphism
differences, we classified the five CRKP isolates into 3 distinct clusters.
Multilocus sequence typing (MLST) and core genome multilocus sequence typing
(cgMLST) identified the main prevalent sequence type of CRKP as
ST11-CT1313.Conclusions: Utilizing WGS for sequence typing, phylogenetic
analysis, and antibiotic resistance gene identification is essential in
enhancing the control and containment of CRKP infections in ICU. However, it is
vital to consider both resistance phenotypes and resistance genes when guiding
clinical medication decisions.