Infection and drug resistance · 2026
Genomic Epidemiology and Antimicrobial Resistance Analyses of bla KPC-2-Producing Pseudomonas aeruginosa in Zhejiang, China.
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Bao Siwen, Zhu Li, Niu Xiaoqin, Tian Junhua, Mao Minjie, Shen Weifeng, Yu Qinlong, Wang Wei
Аннотация
INTRODUCTION: Klebsiella pneumoniae carbapenemase (KPC)-producing carbapenem-resistant Pseudomonas aeruginosa is a global health burden due to its multidrug resistance. However, the resistance characteristics, molecular epidemiology, and dissemination mechanisms of bla KPC-2-producing carbapenem-resistant P. aeruginosa in China remain limited.
METHODS: A total of 23 bla KPC-2-producing carbapenem-resistant P. aeruginosa isolates were collected in a hospital in Jiaxing, Zhejiang, from February 2021 to January 2025. Antimicrobial susceptibility testing and whole-genome sequencing were performed. Multilocus sequence typing, antimicrobial resistance genes, and virulence factors were identified. Phylogenetic analyses were performed, and genetic context analyses were conducted.
RESULTS: Six sequence types (STs) were identified among 23 isolates, with ST463 accounting for 56.5%. All isolates exhibited multidrug-resistant phenotypes and were identified as carbapenem-resistant Pseudomonas aeruginosa. 17.4% of isolates showed resistance to ceftazidime/avibactam (CZA). All ST463 isolates co-harbored exoS and exoU. The core-genome MLST analysis identified two clusters within ST463 isolates, and the core-genome single-nucleotide polymorphism analysis revealed close genomic relatedness among ST4424 and ST4526 isolates. The bla KPC-2 genetic context was mainly associated with an ISKpn27-bla KPC-ISKpn6-like structure and IncU-related sequences.
CONCLUSION: ST463 was identified as the predominance lineage among bla KPC-2-producing carbapenem-resistant P. aeruginosa in this study, and multidrug resistance genes and multiple virulence factor genes in the ST463 were demonstrated. Genomic analyses identified closely related isolates consistent with potential nosocomial transmission in the hospital. These findings highlighted the importance of continuous genomic surveillance, susceptibility monitoring, and strengthened infection control strategies for limiting the persistence and potential nosocomial spread of high-risk bla KPC-2-producing carbapenem-resistant P. aeruginosa.
METHODS: A total of 23 bla KPC-2-producing carbapenem-resistant P. aeruginosa isolates were collected in a hospital in Jiaxing, Zhejiang, from February 2021 to January 2025. Antimicrobial susceptibility testing and whole-genome sequencing were performed. Multilocus sequence typing, antimicrobial resistance genes, and virulence factors were identified. Phylogenetic analyses were performed, and genetic context analyses were conducted.
RESULTS: Six sequence types (STs) were identified among 23 isolates, with ST463 accounting for 56.5%. All isolates exhibited multidrug-resistant phenotypes and were identified as carbapenem-resistant Pseudomonas aeruginosa. 17.4% of isolates showed resistance to ceftazidime/avibactam (CZA). All ST463 isolates co-harbored exoS and exoU. The core-genome MLST analysis identified two clusters within ST463 isolates, and the core-genome single-nucleotide polymorphism analysis revealed close genomic relatedness among ST4424 and ST4526 isolates. The bla KPC-2 genetic context was mainly associated with an ISKpn27-bla KPC-ISKpn6-like structure and IncU-related sequences.
CONCLUSION: ST463 was identified as the predominance lineage among bla KPC-2-producing carbapenem-resistant P. aeruginosa in this study, and multidrug resistance genes and multiple virulence factor genes in the ST463 were demonstrated. Genomic analyses identified closely related isolates consistent with potential nosocomial transmission in the hospital. These findings highlighted the importance of continuous genomic surveillance, susceptibility monitoring, and strengthened infection control strategies for limiting the persistence and potential nosocomial spread of high-risk bla KPC-2-producing carbapenem-resistant P. aeruginosa.