Clinical characteristics and molecular epidemiology of KPC-NDM co-producing carbapenem-resistant Klebsiella pneumoniae in China: a multicentre retrospective case-control study - PubMed
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- #Molecular Epidemiology
- #CRKP
- #KPC-NDM
- Study focuses on KPC-NDM co-producing carbapenem-resistant Klebsiella pneumoniae (KN-CRKP) in China.
- Multicentre retrospective case-control study with 3012 CRKP isolates, 71 (2.4%) were KN-CRKP.
- Patients with KN-CRKP infections had higher in-hospital mortality (46.2%) compared to KPC-CRKP (25.6%).
- Risk factors included diabetes, history of CRO infection treated with CZA, and recent use of β-lactam/β-lactamase inhibitors.
- KN-CRKP isolates were resistant to carbapenems and CZA but susceptible to colistin, cefiderocol, and aztreonam-avibactam.
- Predominant clones were ST11 (73.2%) and ST307 (15.5%).
- Global surveillance identified ST11 as a pandemic lineage with emerging clones ST147/ST307.
- Plasmid profiling revealed blaNDM on IncX3/IncN and blaKPC on IncR/IncFII plasmids, with novel hybrid plasmids identified.
- blaNDM-carrying plasmids had higher transferability/stability than blaKPC-carrying ones.
- In vitro experiments confirmed blaNDM transfer from Citrobacter freundii to blaKPC-carrying K. pneumoniae.