![]() ![]() The ethics committee of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, approved this study (2022–0227). pneumoniae ST15 lineage and provide insights for developing new infection control strategies. Our study provides data that will help monitor global spread and the epidemic expansion of K. We performed large-scale comprehensive genomic epidemiologic analysis to investigate the transmission histories, common ancestors, evolution rates, and population structures of all publicly available bla OXA-232–carrying K. pneumoniae ST15 isolates in China, focusing on the genomic characterization of the lineage and the genetic context of the bla OXA-232–carrying plasmids. We aimed to perform a multicenter molecular epidemiologic study of carbapenem-resistant bla OXA-232–carrying K. pneumoniae isolates has impeded full understanding of the genomic evolution and transmission dynamics of CRKP ( 5, 12). Limited data from previous studies on the number and geographic diversity of bla OXA-232–carrying K. This approach, developed in response to increasing rates of global spread of antimicrobial-resistant bacteria, emphasizes the need to explore transmission of infection from a global rather than a country- or case-specific perspective. Applying a previously proposed reverse genomic epidemiology strategy enabled us to make genome comparisons of isolates to identify shared sources of infection on the basis of genomic similarity ( 11). pneumoniae, mediate low-level carbapenem resistance and many coexist with virulence plasmids ( 6, 9, 10). In China, some strains of sequence type (ST) 15, the predominant lineage of bla OXA-232–carrying K. Most bla OXA-232 genes have been discovered on small and nonconjugative ColKP3-type plasmids ( 8). ![]() Nosocomial outbreaks, including among pediatric patients, have called attention to the importance of better understanding the transmission potential of CRKP isolates carrying the bla OXA-48–like gene ( 4– 6).īla OXA-232, a variant among bla OXA-48 genes with limited carbapenem hydrolytic activity, was initially identified in France in 2011 ( 7). pneumoniae strains carrying a bla OXA-48–like gene in China increased during 2018–2022 ( 3 – 6). One of the most prevalent carbapenemase genes, bla OXA-48 (oxacillin-hydrolyzing β-lactamase), is found predominantly on large and transferable plasmids in bacteria of order Enterobacterales. The production of carbapenemases is the most crucial carbapenem-resistance mechanism in gram-negative bacteria worldwide ( 2). The global spread of carbapenem-resistant Enterobacterales, particularly carbapenem-resistant Klebsiella pneumoniae (CRKP), poses a severe and ongoing public health threat because of high rates of illness and death ( 1). Our research helps identify key forces driving global spread of bla OXA-232–carrying CRKP ST15 lineage and emphasizes the importance of ongoing surveillance of epidemic CRKP. Most recent common ancestor was traced back to 2000 mutations averaged ≈1.7 per year per genome. The lineage originated in the United States, then spread to Europe, Asia, Oceania, and Africa. Analysis grouped 330 global bla OXA-232–carrying ST15 CRKP strains into 5 clades, indicating clonal transmission with small genetic distances among multiple strains. Phylogenetic and phylogeographic analyses revealed all bla OXA-232–carrying CRKP isolates belonged to ST15 lineage and exhibited multidrug resistance. pneumoniae sequence type (ST) 15 strains from 68 countries available in GenBank. To monitor global spread, we conducted a comprehensive genomic epidemiologic study comparing sequences from 21 bla OXA-232–carrying CRKP isolates from China with K. ![]() Prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP) has compromised antimicrobial efficacy against severe infections worldwide. Sun) Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (M.S. Sun) Hangzhou Women's Hospital, Hangzhou (L. 903 Hospital of PLA Joint Logistic Support Force, Hangzhou (Q. Ruan) Zhejiang University School of Medicine Fourth Affiliated Hospital, Hangzhou (J. He) Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou (Y. Jia) Zhejiang Provincial People's Hospital, Hangzhou (F. Jia) Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou (H. Mao) Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou (H. ![]() Shao) Shaoxing University Affiliated Hospital, Shaoxing, China (W. Jiang) Third People's Hospital of Xiaoshan District, Hangzhou (X. Ruan) Wenzhou Medical University Affiliated Wenling Hospital, Taizhou, China (T. Discuss your favorite titles, find a new one to play or share the game you developed.Author affiliations: Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China (Y. ![]()
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