Lu Huimin, Zhang Chuanjun, Zhao Buhui, Li Yan, Qin Shangshang
Department of Pharmacy, Henan Provincial People's Hospital, Zhengzhou, China.
XNA Platform, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China.
Front Microbiol. 2025 May 9;16:1546662. doi: 10.3389/fmicb.2025.1546662. eCollection 2025.
Carbapenem-resistant (CRPA) poses a global threat; however, the epidemiological characteristics and clinical significance of -positive CRPA strains in China remain unclear. In this study, continuous surveillance was conducted from 2018 to 2022 in a hospital in Henan Province, China, and the genomic characteristics of -positive CRPA were elucidated. We characterised the genetic features of -positive CRPA isolates by antimicrobial susceptibility testing, conjugation assays, whole-genome sequencing, large-scale comparative genomics, and bioinformatic analyses. Among 628 CRPA isolates, one -positive multidrug-resistant (MDR) strain, PA19-3158 (ST1123), was identified, with the gene located on a novel 518,222 bp megaplasmid. Additionally, big data analysis revealed the genomic characteristics of -positive CRPA across China. A total of three different gene variants were identified among these isolates, namely (44.12%), (52.94%), and (2.94%). Our findings identified ST463 as the dominant clone among -positive CRPA in different regions of China, with some -positive CRPA isolates from these regions exhibiting high genetic similarity. Notably, all -positive CRPA isolates carried multiple antibiotic resistance genes (ARGs), with approximately 38% co-harboring the carbapenem-resistant gene and approximately 47% co-harboring the tigecycline-resistant gene . Correlation analysis underscored the significant role of mobile genetic elements in facilitating gene transfer. These results highlight the critical need for continuous surveillance of -positive CRPA in clinical settings to mitigate potential risks.
耐碳青霉烯类（CRPA）构成全球威胁；然而，中国blaKPC阳性CRPA菌株的流行病学特征和临床意义仍不清楚。本研究于2018年至2022年在中国河南省一家医院进行持续监测，阐明了blaKPC阳性CRPA的基因组特征。我们通过抗菌药物敏感性试验、接合试验、全基因组测序、大规模比较基因组学和生物信息学分析，对blaKPC阳性CRPA分离株的遗传特征进行了表征。在628株CRPA分离株中，鉴定出一株blaKPC阳性多重耐药（MDR）菌株PA19 - 3158（ST1123），blaKPC基因位于一个新的518,222 bp的大质粒上。此外，大数据分析揭示了中国各地blaKPC阳性CRPA的基因组特征。在这些分离株中总共鉴定出三种不同的blaKPC基因变体，即blaKPC - 2（44.12%）、blaKPC - 3（52.94%）和blaKPC - 4（2.94%）。我们的研究结果确定ST463是中国不同地区blaKPC阳性CRPA中的优势克隆，来自这些地区的一些blaKPC阳性CRPA分离株表现出高度的遗传相似性。值得注意的是，所有blaKPC阳性CRPA分离株都携带多个抗生素耐药基因（ARGs），约38%共同携带耐碳青霉烯类基因blaNDM，约47%共同携带耐替加环素基因tet(X)。相关性分析强调了移动遗传元件在促进blaKPC基因转移中的重要作用。这些结果凸显了在临床环境中持续监测blaKPC阳性CRPA以降低潜在风险的迫切需求。
