# Genomic analysis of Klebsiella aerogenes circulating in New Mexico

## TL;DR

This study uses genomic analysis to understand the spread and resistance patterns of Klebsiella aerogenes in New Mexico, revealing key lineages and resistance mechanisms.

## Contribution

A novel species-specific PopPUNK database was developed for high-resolution typing of K. aerogenes.

## Key findings

- Two global pandemic lineages, ST93 and ST4, dominated the New Mexico K. aerogenes population.
- Genomic evidence of recent local transmission was rare, with only four putative transmission pairs identified.
- Mutations in AmpD and Omp36 were common and linked to increased carbapenem resistance in the ST93 lineage.

## Abstract

Klebsiella aerogenes is an opportunistic pathogen and a growing cause of healthcare-associated infections, characterized by multidrug resistance and the emergence of global high-risk clones. However, regional genomic surveillance data remain limited. Here, we sought to characterize the population structure, transmission dynamics and resistance mechanisms of clinical K. aerogenes in Albuquerque, New Mexico. We sequenced 177 clinical isolates collected between 2021 and 2023. We also developed a novel, species-specific PopPUNK database to facilitate rapid, high-resolution typing. The New Mexico K. aerogenes population was diverse but dominated by two global pandemic lineages, ST93 (47.5%) and ST4 (7.9%), which were significantly enriched for the virulence factors yersiniabactin and colibactin. Genomic evidence for recent local transmission was rare, with only four putative transmission pairs identified. The resistome was characterized by intrinsic and adaptive mutations. Nearly all isolates possessed gyrA mutations associated with decreased fluoroquinolone susceptibility. Mutations in the AmpC regulator AmpD and the outer membrane porin Omp36 were common, particularly within the dominant ST93 lineage. These mutations have been associated with increased AmpC-mediated carbapenem resistance. Our findings underscore the critical importance of genomic surveillance to monitor the transmission and evolution of adaptive resistance.