Carbapenem-Resistant, Virulence Plasmid–Harboring Klebsiella pneumoniae, United States

Jianping Jiang; Tengfei Long; Adeline R. Porter; Arianne Lovey; Annie Lee; Jesse Thomas Jacob; Cesar A. Arias; Robert Bonomo; Robert Kalayjian; Yanan Zhao; Frank R. DeLeo; David van Duin; Barry N. Kreiswirth; Liang Chen

doi:10.3201/eid3104.241396

Carbapenem-Resistant, Virulence Plasmid–Harboring Klebsiella pneumoniae, United States

Jianping Jiang, Tengfei Long, Adeline R. Porter, Arianne Lovey, Annie Lee, Jesse Thomas Jacob, Cesar A. Arias, Robert Bonomo, Robert Kalayjian, Yanan Zhao, Frank R. DeLeo, David van Duin, Barry N. Kreiswirth, Liang Chen

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Carbapenem-resistant and virulence plasmid–harboring Klebsiella pneumoniae (pVir-CRKP) has emerged and spread globally, yet clinical investigations from the United States remain limited. We conducted a genomic analysis of 884 unique carbapenem-resistant K. pneumoniae isolates from a multicenter US cohort and identified 6 pVir-CRKP isolates, including 2 sequence type (ST) 23, 2 ST893, and 2 ST11 isolates. Patients infected with pVir-CRKP experienced high Pitt bacteremia scores and a 33% 30-day mortality rate. The pVir-CRKP isolates exhibited significant sequence variation in virulence genes and plasmids, along with differences in mucoviscosity, capsule production, survival in normal human serum, resistance to killing by human polymorphonuclear neutrophils, and in vivo pathogenicity. Phylogenetic analyses showed that most pVir-CRKP isolates were genetically similar to strains reported from other global regions. The emergence of pVir-CRKP with higher virulence potential and carbapenem resistance in the United States than the predominant carbapenem-resistant K. pneumoniae clone underscores the need for active global surveillance.

Original language	English (US)
Pages (from-to)	761-771
Number of pages	11
Journal	Emerging Infectious Diseases
Volume	31
Issue number	4
DOIs	https://doi.org/10.3201/eid3104.241396
State	Published - Apr 2025

ASJC Scopus subject areas

Epidemiology
Microbiology (medical)
Infectious Diseases

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title = "Carbapenem-Resistant, Virulence Plasmid–Harboring Klebsiella pneumoniae, United States",

abstract = "Carbapenem-resistant and virulence plasmid–harboring Klebsiella pneumoniae (pVir-CRKP) has emerged and spread globally, yet clinical investigations from the United States remain limited. We conducted a genomic analysis of 884 unique carbapenem-resistant K. pneumoniae isolates from a multicenter US cohort and identified 6 pVir-CRKP isolates, including 2 sequence type (ST) 23, 2 ST893, and 2 ST11 isolates. Patients infected with pVir-CRKP experienced high Pitt bacteremia scores and a 33% 30-day mortality rate. The pVir-CRKP isolates exhibited significant sequence variation in virulence genes and plasmids, along with differences in mucoviscosity, capsule production, survival in normal human serum, resistance to killing by human polymorphonuclear neutrophils, and in vivo pathogenicity. Phylogenetic analyses showed that most pVir-CRKP isolates were genetically similar to strains reported from other global regions. The emergence of pVir-CRKP with higher virulence potential and carbapenem resistance in the United States than the predominant carbapenem-resistant K. pneumoniae clone underscores the need for active global surveillance.",

author = "Jianping Jiang and Tengfei Long and Porter, {Adeline R.} and Arianne Lovey and Annie Lee and Jacob, {Jesse Thomas} and Arias, {Cesar A.} and Robert Bonomo and Robert Kalayjian and Yanan Zhao and DeLeo, {Frank R.} and {van Duin}, David and Kreiswirth, {Barry N.} and Liang Chen",

year = "2025",

month = apr,

doi = "10.3201/eid3104.241396",

language = "English (US)",

volume = "31",

pages = "761--771",

journal = "Emerging Infectious Diseases",

issn = "1080-6040",

publisher = "Centers for Disease Control and Prevention (CDC)",

number = "4",

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T1 - Carbapenem-Resistant, Virulence Plasmid–Harboring Klebsiella pneumoniae, United States

AU - Jiang, Jianping

AU - Long, Tengfei

AU - Porter, Adeline R.

AU - Lovey, Arianne

AU - Lee, Annie

AU - Jacob, Jesse Thomas

AU - Arias, Cesar A.

AU - Bonomo, Robert

AU - Kalayjian, Robert

AU - Zhao, Yanan

AU - DeLeo, Frank R.

AU - van Duin, David

AU - Kreiswirth, Barry N.

AU - Chen, Liang

PY - 2025/4

Y1 - 2025/4

N2 - Carbapenem-resistant and virulence plasmid–harboring Klebsiella pneumoniae (pVir-CRKP) has emerged and spread globally, yet clinical investigations from the United States remain limited. We conducted a genomic analysis of 884 unique carbapenem-resistant K. pneumoniae isolates from a multicenter US cohort and identified 6 pVir-CRKP isolates, including 2 sequence type (ST) 23, 2 ST893, and 2 ST11 isolates. Patients infected with pVir-CRKP experienced high Pitt bacteremia scores and a 33% 30-day mortality rate. The pVir-CRKP isolates exhibited significant sequence variation in virulence genes and plasmids, along with differences in mucoviscosity, capsule production, survival in normal human serum, resistance to killing by human polymorphonuclear neutrophils, and in vivo pathogenicity. Phylogenetic analyses showed that most pVir-CRKP isolates were genetically similar to strains reported from other global regions. The emergence of pVir-CRKP with higher virulence potential and carbapenem resistance in the United States than the predominant carbapenem-resistant K. pneumoniae clone underscores the need for active global surveillance.

AB - Carbapenem-resistant and virulence plasmid–harboring Klebsiella pneumoniae (pVir-CRKP) has emerged and spread globally, yet clinical investigations from the United States remain limited. We conducted a genomic analysis of 884 unique carbapenem-resistant K. pneumoniae isolates from a multicenter US cohort and identified 6 pVir-CRKP isolates, including 2 sequence type (ST) 23, 2 ST893, and 2 ST11 isolates. Patients infected with pVir-CRKP experienced high Pitt bacteremia scores and a 33% 30-day mortality rate. The pVir-CRKP isolates exhibited significant sequence variation in virulence genes and plasmids, along with differences in mucoviscosity, capsule production, survival in normal human serum, resistance to killing by human polymorphonuclear neutrophils, and in vivo pathogenicity. Phylogenetic analyses showed that most pVir-CRKP isolates were genetically similar to strains reported from other global regions. The emergence of pVir-CRKP with higher virulence potential and carbapenem resistance in the United States than the predominant carbapenem-resistant K. pneumoniae clone underscores the need for active global surveillance.

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Carbapenem-Resistant, Virulence Plasmid–Harboring Klebsiella pneumoniae, United States

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