A systematic analysis of various clonal lineages of colistin-resistant Klebsiella pneumoniae with mgrB mutations.

Klebsiella pneumoniae poses a significant health threat due to their pathogenicity and high propensity to acquire resistance to wide range of antimicrobial agents. Colistin, a non-ribosomal secondary cationic amphipathic peptide, exhibits bactericidal activity. Despite its known nephrotoxic and neurotoxic effects, colistin remains in use for treating multidrug-resistant bacterial infections. However, the widespread use of colistin has led to the global emergence of colistin-resistant K. pneumoniae strains. This review investigates the global epidemiology of various clonal lineages of colistin-resistant K. pneumoniae. A comprehensive search was conducted across various databases, including PubMed, ScienceDirect, and Google Scholar. A total of 81 distinct colistin-resistant K. pneumoniae sequence types were identified worldwide, with the highest clonal diversity observed in India and China (n = 16), followed by South Korea (n = 15), Brazil (n = 14), France and Saudi Arabia (n = 12), Nigeria (n = 11), Colombia (n = 9), and Italy and Taiwan (n = 8). eBURST analysis grouped 87 colistin-resistant sequence types into 51 singletons and 9 clonal complexes, forming 5 distinct clonal groups. The findings indicate a broad global distribution of colistin-resistant K. pneumoniae clones, marked by diverse mgrB mutations. This underscores the urgent need for robust monitoring and surveillance to curb the development and dissemination of colistin-resistant K. pneumoniae and to ensure effective infection control measures.