Prevalence and Molecular Characteristics of Klebsiella pneumoniae Harboring the Pks Island from Cancer Patients in China.

PURPOSE: Klebsiella pneumoniae harbors a gene cluster, polyketide synthase island (PKS), which is responsible for colibactin synthesis which induces double-stranded DNA breaks and associated with increased pathogenicity and cancer development. However, there is limited information on pks-positive K. pneumoniae in cancer patients in China. This study aimed to investigate the prevalence and molecular characteristics of K. pneumoniae harboring the pks island in patients with cancer in China and to explore its potential pathogenicity and clinical significance.

METHODS

Among 279 nonrepetitive K. pneumoniae isolated from all cancer patients in China, the presence of pks genes were determined by PCR and the molecular characteristics were detected by whole-genome sequencing. Clinical characteristics and antimicrobial susceptibility were also investigated.

RESULTS

The pks gene cluster was detected in 35 (12.54%) of the 279 isolates. All isolates were less resistant to most antimicrobial agents, and there were no significant differences in the rates of susceptibility between pks-positive and pks-negative isolates to most antibiotics, except for sulfonamides. Among pks-positive isolates, ST23 (19, 54.29%) and K1 (17, 48.57%) were the dominant sequence types and serotypes, respectively, and the majority harbored multiple virulence genes, including aerobactin, enterobactin, salmochelin, and yersiniabactin.

CONCLUSION

The distribution of pks-positive K. pneumoniae in different types of cancer combined with its hypervirulent determinants highlighted the potential pathogenicity of genotoxins, which requires close clinical attention and epidemic tracking.