# Clinical phenotype and molecular characteristics of carbapenem-resistant hypervirulent Klebsiella pneumoniae causing multi-site infection

## TL;DR

This study examines three drug-resistant, highly virulent Klebsiella pneumoniae strains from a single patient, showing they cause multi-site infections and emphasizing the need for better infection control.

## Contribution

The paper reports on the molecular and clinical characteristics of CR-hvKp strains causing multi-site infections in one patient, highlighting their resistance and virulence profiles.

## Key findings

- All three K. pneumoniae strains were carbapenem-resistant and carried the KPC resistance gene.
- The strains exhibited high virulence due to genes like rmpA2, iroB, and iutA.
- The strains caused multi-site infections through hematogenous dissemination.

## Abstract

To analyze the clinical phenotype and molecular characteristics of three Carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKp) strains isolated from different sites of the same patient, providing an experimental basis for clinical anti-infection treatment and nosocomial infection prevention and control.

The collected strains were tested for antimicrobial susceptibility using an automatic drug sensitivity analyzer. Whole-genome sequencing was performed to analyze the presence of resistance and virulence genes and to determine the classification and homology of the three strains.

The three K. pneumoniae strains were classified as ST11/K47/O13. Whole-genome sequencing revealed that all strains carried the KPC-type carbapenemase gene, and the high-virulence genes, rmpA2, iroB and iutA, along with three plasmids. Antimicrobial susceptibility testing showed that all strains were resistant to carbapenems, including imipenem and meropenem.

The three clinically isolated K. pneumoniae strains were highly virulent and carbapenem-resistant, all carrying the KPC resistance gene. They caused multi-site infections through hematogenous dissemination. These findings highlight the need for heightened clinical vigilance and strengthened monitoring, prevention, and control of drug-resistant infections.