Zhang Yuan, Wang Mengyu, Li Zhenpeng, Peng Yao, Yang Yuhan, Liu Xiao, Li Zhe, Kan Biao, Zeng Mei, Lu Xin
National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
Gut Pathog. 2025 May 27;17(1):36. doi: 10.1186/s13099-025-00700-9.
Klebsiella pneumoniae producing extended-spectrum β-lactamase (ESBL) colonizing and transmitting in the intestine, especially in children, have significant public health implications. Investigating antibiotic resistance, antibiotic resistance genes (ARGs), virulence factor genes (VFGs), and genetic relationships may help us to explore the characteristics and differences of ESBL-positive K. pneumoniae in children with and without diarrhea.
After selecting and pairing, 26 pairs of 52 ESBL-positive K. pneumoniae strains were isolated from 323 children with diarrhea and 393 children without diarrhea. Antimicrobial susceptibility test and whole genome sequencing were performed to explore antibiotic resistance, ARGs, and VFGs. The genetic relationship was explored by conducting a maximum likelihood phylogenetic tree and investigating plasmid and sequence type (ST).
All strains showed resistance to cephalosporins, with ESBL-producing genes widely carried (98.1%). Carbapenem-resistant K. pneumoniae (CRKP) were found in both groups. Hypervirulent K. pneumoniae (hvKP) were isolated from children with diarrhea carrying iucA on plasmid. The emergence of ST5670 CRKP and ST2108 hvKP highlighted the necessity for close monitoring of community-acquired K. pneumoniae.
Severe drug resistance was found among ESBL-positive K. pneumoniae strains isolated from children with and without diarrhea. Attention must be paid to ESBL-positive K. pneumoniae colonized in the intestine of children, and pathogen and ARG monitoring in children should be strengthened, even in healthy people.
产超广谱β-内酰胺酶（ESBL）的肺炎克雷伯菌在肠道内定植和传播，尤其是在儿童中，具有重大的公共卫生意义。研究抗生素耐药性、抗生素耐药基因（ARG）、毒力因子基因（VFG）以及遗传关系，可能有助于我们探索腹泻和非腹泻儿童中ESBL阳性肺炎克雷伯菌的特征和差异。
经过筛选和配对，从323例腹泻儿童和393例非腹泻儿童中分离出26对共52株ESBL阳性肺炎克雷伯菌菌株。进行药敏试验和全基因组测序，以探索抗生素耐药性、ARG和VFG。通过构建最大似然系统发育树以及研究质粒和序列类型（ST）来探索遗传关系。
所有菌株均对头孢菌素耐药，广泛携带产ESBL基因（98.1%）。两组均发现了耐碳青霉烯类肺炎克雷伯菌（CRKP）。从腹泻儿童中分离出携带质粒上iucA的高毒力肺炎克雷伯菌（hvKP）。ST5670 CRKP和ST2108 hvKP的出现凸显了密切监测社区获得性肺炎克雷伯菌的必要性。
从腹泻和非腹泻儿童中分离出的ESBL阳性肺炎克雷伯菌菌株存在严重耐药情况。必须关注定植于儿童肠道内的ESBL阳性肺炎克雷伯菌，即使在健康人群中，也应加强对儿童病原体和ARG的监测。
