Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases · 2026
Phylogenetic structure and clinical implications of carbapenemase-aerobactin (iuc) convergence in respiratory Klebsiella pneumoniae from a tertiary hospital in China, 2017-2023.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zhou Han, Wu Zhenchao, Yang Ping, Lu Ming, Zheng Jiajia, Wu Rui, Shen Ning
Аннотация
OBJECTIVES: To characterise the phylogenetic structure and clinical implications of carbapenemase-aerobactin (iuc) convergence among respiratory Klebsiella pneumoniae isolates.
METHODS: We performed whole-genome sequencing of 707 non-duplicate respiratory K. pneumoniae isolates collected at a tertiary hospital in China from 2017 to 2023 and linked the genomic data to blinded clinical adjudication. Isolates were grouped by carbapenemase gene carriage and iuc status. Core-genome SNP phylogenies were constructed for ST11 and ST23, and reference-plasmid mapping to pK2044 was performed in a targeted subset. Within the carbapenemase-positive subset, logistic regression was used to test the incremental contribution of iuc beyond age, Charlson Comorbidity Index, and ICU admission during hospitalisation. All-cause mortality at 14, 28, and 90 days was assessed among infection cases.
RESULTS: Overall, 548/707 isolates (77.5%) were adjudicated as infection, including 280 community-acquired pneumonia and 268 hospital-acquired pneumonia cases. Seventy-nine isolates (11.2%) were classified as carb+/iuc+, and 74/79 (93.7%) belonged to ST11. Phylogenetic analysis showed that convergence was concentrated in lineage-restricted ST11 branches, particularly KL64/KL47-associated backgrounds, whereas ST23 formed a more dispersed classical iuc-positive lineage background. Carb-/iuc+ ST23 retained a conserved hypervirulence-associated module and showed high compatibility with pK2044, whereas carb+/iuc+ ST11 showed a more fragmented virulence profile and heterogeneous, incomplete pK2044 coverage. Within the carbapenemase-positive subset, adding iuc to a model including age, Charlson Comorbidity Index, and ICU admission during hospitalisation did not improve infection attribution (adjusted OR 0.93, 95% CI 0.33-2.68; likelihood ratio test P = 0.892; ΔAIC = 1.98). Among infection cases, carb+/iuc+ and carb+/iuc- groups showed broadly similar all-cause mortality at 14, 28, and 90 days.
CONCLUSIONS: Carbapenemase-aerobactin convergence among respiratory K. pneumoniae was concentrated in dominant ST11 backgrounds and occurred in distinct lineage-specific virulence contexts. However, within the carbapenemase-positive respiratory subset, iuc added limited value for infection attribution and did not clearly separate short- to intermediate-term mortality beyond host and care-setting factors.
METHODS: We performed whole-genome sequencing of 707 non-duplicate respiratory K. pneumoniae isolates collected at a tertiary hospital in China from 2017 to 2023 and linked the genomic data to blinded clinical adjudication. Isolates were grouped by carbapenemase gene carriage and iuc status. Core-genome SNP phylogenies were constructed for ST11 and ST23, and reference-plasmid mapping to pK2044 was performed in a targeted subset. Within the carbapenemase-positive subset, logistic regression was used to test the incremental contribution of iuc beyond age, Charlson Comorbidity Index, and ICU admission during hospitalisation. All-cause mortality at 14, 28, and 90 days was assessed among infection cases.
RESULTS: Overall, 548/707 isolates (77.5%) were adjudicated as infection, including 280 community-acquired pneumonia and 268 hospital-acquired pneumonia cases. Seventy-nine isolates (11.2%) were classified as carb+/iuc+, and 74/79 (93.7%) belonged to ST11. Phylogenetic analysis showed that convergence was concentrated in lineage-restricted ST11 branches, particularly KL64/KL47-associated backgrounds, whereas ST23 formed a more dispersed classical iuc-positive lineage background. Carb-/iuc+ ST23 retained a conserved hypervirulence-associated module and showed high compatibility with pK2044, whereas carb+/iuc+ ST11 showed a more fragmented virulence profile and heterogeneous, incomplete pK2044 coverage. Within the carbapenemase-positive subset, adding iuc to a model including age, Charlson Comorbidity Index, and ICU admission during hospitalisation did not improve infection attribution (adjusted OR 0.93, 95% CI 0.33-2.68; likelihood ratio test P = 0.892; ΔAIC = 1.98). Among infection cases, carb+/iuc+ and carb+/iuc- groups showed broadly similar all-cause mortality at 14, 28, and 90 days.
CONCLUSIONS: Carbapenemase-aerobactin convergence among respiratory K. pneumoniae was concentrated in dominant ST11 backgrounds and occurred in distinct lineage-specific virulence contexts. However, within the carbapenemase-positive respiratory subset, iuc added limited value for infection attribution and did not clearly separate short- to intermediate-term mortality beyond host and care-setting factors.