On Younggwon, Kim Jung Wook, Lee Juyoung, Yoo Jung Sik
Division of Antimicrobial Resistance Research, Center for Infectious Disease, National Institute of Health, Korea, Cheongju, South Korea.
Division of Zoonotic and Vector Borne Diseases Research, Center for Infectious Disease, National Institute of Health, Korea, Cheongju, South Korea.
Front Microbiol. 2025 May 6;16:1562222. doi: 10.3389/fmicb.2025.1562222. eCollection 2025.
Carbapenem-resistant (CRKP) poses a significant threat to public health owing to its multidrug resistance and rapid dissemination.
This study analyzed CRKP isolates collected from bloodstream infections in nine regions of South Korea using the Kor-GLASS surveillance system between 2017 and 2021.
A total of 3,941 isolates were collected. Among them, 119 (3%) isolates were identified as CRKP. Most CRKP (79.7%) belonged to sequence type 307 (ST307), followed by ST11 (6.8%). All CRKP isolates exhibited multidrug resistance, with 78.8% carrying the IncX3 plasmid encoding the gene. Phylogenetic and genomic analyses revealed that ST307 isolates exhibited low single nucleotide polymorphism (SNP) differences. SNP differences among ST307 strains ranged from a minimum of 1 to a maximum of 140, indicating close genetic relatedness. All ST307 strains harbored the KL102 and O1/O2v2 loci, and genomic analysis revealed high prevalence of key resistance genes such as (91.5%) and (83.9%), alongside mutations in the (ParC-80I, GyrA-83I) and genes. Two major clusters were identified, with cluster 1 harboring yersiniabactin lineage 16 (ICEkp12) and cluster 2 showing higher virulence, including the yersiniabactin lineage 17 (ICEkp10) and colibactin-associated genes.
These findings underscore the dominance of ST307 among CRKP isolates in Korea, which is driven by clonal expansion and the critical role of mobile genetic elements. Therefore, enhanced genomic surveillance and targeted infection control measures are urgently required to address the spread of CRKP in clinical settings.
耐碳青霉烯类肺炎克雷伯菌（CRKP）因其多重耐药性和快速传播，对公众健康构成重大威胁。
本研究利用韩国Kor-GLASS监测系统，分析了2017年至2021年期间从韩国九个地区血流感染中分离出的CRKP菌株。
共收集到3941株菌株。其中，119株（3%）被鉴定为CRKP。大多数CRKP（79.7%）属于序列型307（ST307），其次是ST11（6.8%）。所有CRKP菌株均表现出多重耐药性，78.8%携带编码该基因的IncX3质粒。系统发育和基因组分析表明，ST307菌株的单核苷酸多态性（SNP）差异较小。ST307菌株之间的SNP差异最小为1，最大为140，表明遗传关系密切。所有ST307菌株均携带KL102和O1/O2v2位点，基因组分析显示关键耐药基因如（91.5%）和（83.9%）的高流行率，以及（ParC-80I，GyrA-83I）和基因的突变。鉴定出两个主要聚类，聚类1含有耶尔森菌素谱系16（ICEkp12），聚类2显示出更高的毒力，包括耶尔森菌素谱系17（ICEkp10）和与大肠杆菌素相关的基因。
这些发现强调了ST307在韩国CRKP分离株中的主导地位，这是由克隆扩张和移动遗传元件的关键作用驱动的。因此，迫切需要加强基因组监测和针对性的感染控制措施，以应对CRKP在临床环境中的传播。
