Genomic Analysis of Carbapenem-Resistant Isolated from Bloodstream Infections in South Korea.

BACKGROUND/OBJECTIVES: Bloodstream infection by carbapenem-resistant (CRAB) is a serious clinical problem worldwide. To study its clonal relationship and genetic features, we report the draft genome sequence of CRAB strains isolated from human blood in South Korea.

METHODS

Among strains isolated from patients at nine general hospitals in 2020, 12 CRAB strains of different genotypes were selected. Genomic DNA was sequenced using a combination of Illumina MiSeq and Oxford Nanopore MinION platforms. Antimicrobial susceptibility testing was performed using the disk diffusion method. Antimicrobial resistance and virulence genes were investigated in silico using the Center for Genomic Epidemiology server and the Virulence Factors Database.

RESULTS

The multilocus sequence types of isolates included ST191, ST195, ST357, ST369, ST451, ST469, ST491, ST784, ST862, ST1933, ST2929, and a novel type, ST3326. The predominant sequence type, ST191, demonstrated close genetic relationships with several isolates, including ST469, ST369, ST195, ST784, ST491, and ST3326, with ST3326 classified as a subgroup of ST191. We found 18 antimicrobial resistance genes and one quaternary ammonium compound resistance gene. All examined strains harbored , which is associated with carbapenem resistance. While variations in antibiotic and disinfectant resistance genes were observed, all isolates exhibited similar virulence factors, with the exception of the biofilm and capsule production genes.

CONCLUSIONS

This nationwide report of the draft genome sequence of patient-derived strains provides valuable insights into the genomic features associated with clonal relationships and antimicrobial resistance of CRAB in bloodstream infections.