Department of Clinical Laboratory, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
Int J Antimicrob Agents. 2024 Aug;64(2):107225. doi: 10.1016/j.ijantimicag.2024.107225. Epub 2024 May 28.
bla and bla are responsible for the global increase in carbapenem-resistant Klebsiella pneumoniae, posing a great challenge to public health. However, the impact of phylogenetic factors on the dissemination of bla and bla is not yet fully understood This study established a global dataset of 4051 bla+ and 10,223 bla+ K. pneumoniae genomes, and compared their transmission modes on a global scale. The results showed that bla+ K. pneumoniae genomes exhibited a broader geographical distribution and higher sequence type (ST) richness than bla+ genomes, indicating higher transmissibility of the bla gene. Furthermore, bla+ genomes displayed significant differences in ST lineage, antibiotic resistance gene composition, virulence gene composition and genetic environments compared with bla+ genomes, suggesting distinct dissemination mechanisms. bla+ genomes were predominantly associated with ST147 and ST16, whereas bla+ genomes were mainly found in ST11 and ST258. Significantly different accessory genes were identified between bla+ and bla+ genomes. The preference for bla distribution across certain countries, ST lineages and genetic environments underscores vertical spread as the primary mechanism driving the expansion of bla. In contrast, bla+ genomes did not display such a strong preference, confirming that the dissemination of bla mainly depends on horizontal gene transfer. Overall, this study demonstrates different phylogenetic drivers for the dissemination of bla and bla, providing new insights into their global transmission dynamics.
bla 和 bla 负责全球碳青霉烯类耐药肺炎克雷伯菌的增加，对公共卫生构成了巨大挑战。然而，进化因素对 bla 和 bla 传播的影响尚不完全清楚。本研究建立了一个包含 4051 株 bla+和 10223 株 bla+肺炎克雷伯菌基因组的全球数据集，并在全球范围内比较了它们的传播模式。结果表明，bla+肺炎克雷伯菌基因组的地理分布范围更广，序列型（ST）丰富度更高，表明 bla 基因的传播能力更强。此外，bla+基因组在 ST 谱系、抗生素耐药基因组成、毒力基因组成和遗传环境方面与 bla+基因组存在显著差异，表明存在不同的传播机制。bla+基因组主要与 ST147 和 ST16 相关，而 bla+基因组主要存在于 ST11 和 ST258 中。bla+和 bla+基因组之间存在显著不同的辅助基因。bla 在某些国家、ST 谱系和遗传环境中的分布偏好表明垂直传播是驱动 bla 扩展的主要机制。相比之下，bla+基因组没有表现出如此强烈的偏好，这证实了 bla 的传播主要依赖于水平基因转移。总体而言，本研究表明 bla 和 bla 的传播存在不同的进化驱动因素，为它们的全球传播动态提供了新的见解。
