BMC infectious diseases · 2026
Clinical and molecular characterizations of carbapenem-resistant Klebsiella pneumoniae among children with bloodstream infections in Beijing, China.
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Li Jing, Song Zexuan, Xu Wenjian, Zhou Lin, Yu Li, Tian Meng, Zhang Xin, Ma Lijuan
Аннотация
BACKGROUND: Bloodstream infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) in children pose a significant challenge to global public health and place tremendous pressure on clinical antibiotic treatment. A longitudinal retrospective study was designed to elucidate the clinical features, antibiotic resistance phenotypes, and molecular characteristics of CRKP isolated from bloodstream infections in children.
METHODS: CRKP strains were collected from blood cultures over an eight-year period (2018-2025) at a tertiary children's hospital in Beijing, China. Antimicrobial susceptibility testing and whole-genome sequencing (WGS) were performed to examine the resistance patterns and genetic diversity.
RESULTS: CRKP bloodstream infections exhibited a distinct age-related pattern, with the highest incidence observed in infants younger than 3 months. Among the 91 isolates studied, none showed resistance to tigecycline or polymyxin B. The predominant carbapenemase genes identified were blaKPC-2 (52.7%) and blaNDM variants (40.7%), among which blaNDM-5 was the most prevalent. Strains carrying only blaKPC-2 were susceptible to ceftazidime/avibactam, whereas all strains harboring blaNDM genes demonstrated 100% resistance to this antibiotic. ST11-KL47(49.5%) was the predominant type and was strongly associated with blaKPC-2 and the 16S rRNA methyltransferase gene rmtB. Additionally, ST20-KL28 (15.4%) was prevalent and closely linked to blaNDM-5. Although ST11-KL64 (3.3%) constituted a minor proportion of isolates, all strains within this clone harbored notable virulence genes.
CONCLUSION: Pediatric CRKP bloodstream infections, predominantly affect young infants and are mediated primarily by blaKPC and blaNDM type carbapenemases. The dominant epidemic clones are ST11-KL47 and ST20-KL28, specifically linked to blaKPC-2 and blaNDM-5, respectively. Although ST11-KL64 accounted for only a limited proportion of the isolates, the virulence genes carried by this clone merit particular concern. These findings elucidate the molecular epidemiology of CRKP in children and provide a foundation for developing effective diagnostic, therapeutic, and preventive strategies.
METHODS: CRKP strains were collected from blood cultures over an eight-year period (2018-2025) at a tertiary children's hospital in Beijing, China. Antimicrobial susceptibility testing and whole-genome sequencing (WGS) were performed to examine the resistance patterns and genetic diversity.
RESULTS: CRKP bloodstream infections exhibited a distinct age-related pattern, with the highest incidence observed in infants younger than 3 months. Among the 91 isolates studied, none showed resistance to tigecycline or polymyxin B. The predominant carbapenemase genes identified were blaKPC-2 (52.7%) and blaNDM variants (40.7%), among which blaNDM-5 was the most prevalent. Strains carrying only blaKPC-2 were susceptible to ceftazidime/avibactam, whereas all strains harboring blaNDM genes demonstrated 100% resistance to this antibiotic. ST11-KL47(49.5%) was the predominant type and was strongly associated with blaKPC-2 and the 16S rRNA methyltransferase gene rmtB. Additionally, ST20-KL28 (15.4%) was prevalent and closely linked to blaNDM-5. Although ST11-KL64 (3.3%) constituted a minor proportion of isolates, all strains within this clone harbored notable virulence genes.
CONCLUSION: Pediatric CRKP bloodstream infections, predominantly affect young infants and are mediated primarily by blaKPC and blaNDM type carbapenemases. The dominant epidemic clones are ST11-KL47 and ST20-KL28, specifically linked to blaKPC-2 and blaNDM-5, respectively. Although ST11-KL64 accounted for only a limited proportion of the isolates, the virulence genes carried by this clone merit particular concern. These findings elucidate the molecular epidemiology of CRKP in children and provide a foundation for developing effective diagnostic, therapeutic, and preventive strategies.
Предметные рубрики MeSH
HumansKlebsiella pneumoniaeKlebsiella InfectionsInfantMaleAnti-Bacterial AgentsMicrobial Sensitivity TestsChild, PreschoolRetrospective StudiesBeijingFemaleChildBacteremiaWhole Genome SequencingBacterial ProteinsCarbapenemsLongitudinal StudiesCarbapenem-Resistant Enterobacteriaceaebeta-LactamasesInfant, NewbornDrug Resistance, Multiple, Bacterial