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已发表论文
产两种碳青霉烯酶的肺炎克雷伯菌：分子研究现状如何
Authors Yu Q, Li G, Xu Q, Zhu Y
Received 28 May 2025
Accepted for publication 5 September 2025
Published 15 September 2025 Volume 2025:18 Pages 4917—4929
DOI https://doi.org/10.2147/IDR.S537638
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 5
Editor who approved publication: Dr Hemant Joshi
Qian Yu,1 Gaosha Li,1 Qianqian Xu,2 Yijun Zhu1
1Department of Clinical Laboratory, Affiliated Jinhua Hospital, Zhejiang University School of Medicine (Jinhua Municipal Central Hospital), Jinhua, Zhejiang, People’s Republic of China; 2Jinhua Prefectural Center for Disease Control and Prevention, Jinhua, Zhejiang, People’s Republic of China
Correspondence: Yijun Zhu, Department of Clinical Laboratory, Affiliated Jinhua Hospital, Zhejiang University School of Medicine (Jinhua Municipal Central Hospital), No. 365 Renmin East Road, Jinhua, Zhejiang Province, 321000, People’s Republic of China, Tel +8657982553839, Email zhuyijunwz@sina.com
Abstract: Klebsiella pneumoniae is a significant pathogen causing various infections. Since the 1990s, carbapenem-resistant Klebsiella pneumoniae (CRKP) has threatened global health. Its main resistance mechanism is producing carbapenemases like KPC, NDM, OXA, IMP and VIM, which have different prevalent isoforms and resistance features. In China, KPC is the most common carbapenemase in CRKP, followed by metallo-β-lactamase (MBL). Alarmingly, an increasing number of K. pneumoniae strains carry two or more types of enzymes, making resistance more complex. This review summarizes the major carbapenemases carried by K. pneumoniae, their global spread, and plasmids of CRKP enzyme type combinations reported in existing studies. Common combinations such as KPC + metalloenzyme, bimetallic enzyme, and metalloenzyme + OXA-48 are discussed in detail, including their genetic environments and transfer characteristics. Whole genome sequencing technology plays a crucial role in studying drug resistance genes of K. pneumoniae, facilitating in - depth identification and analysis of bacteria, and being useful for outbreak investigation and epidemiological surveillance. In conclusion, resistance genes in K. pneumoniae are often located on mobile elements. Different resistance genes tend to be carried by specific plasmids, which have high transformation rates and little impact on host growth. In order to prevent the emergence of Klebsiella pneumoniae carrying multiple drug-resistant genes, several measures such as the rational use of antibiotics, earlier monitoring of the transmission trajectory of strains, and the prediction of the development direction of drug resistance as much as possible are particularly important in the world today.
Keywords: Klebsiella pneumoniae, two carbapenemases, whole genome sequencing
1Department of Clinical Laboratory, Affiliated Jinhua Hospital, Zhejiang University School of Medicine (Jinhua Municipal Central Hospital), Jinhua, Zhejiang, People’s Republic of China; 2Jinhua Prefectural Center for Disease Control and Prevention, Jinhua, Zhejiang, People’s Republic of China
Correspondence: Yijun Zhu, Department of Clinical Laboratory, Affiliated Jinhua Hospital, Zhejiang University School of Medicine (Jinhua Municipal Central Hospital), No. 365 Renmin East Road, Jinhua, Zhejiang Province, 321000, People’s Republic of China, Tel +8657982553839, Email zhuyijunwz@sina.com
Abstract: Klebsiella pneumoniae is a significant pathogen causing various infections. Since the 1990s, carbapenem-resistant Klebsiella pneumoniae (CRKP) has threatened global health. Its main resistance mechanism is producing carbapenemases like KPC, NDM, OXA, IMP and VIM, which have different prevalent isoforms and resistance features. In China, KPC is the most common carbapenemase in CRKP, followed by metallo-β-lactamase (MBL). Alarmingly, an increasing number of K. pneumoniae strains carry two or more types of enzymes, making resistance more complex. This review summarizes the major carbapenemases carried by K. pneumoniae, their global spread, and plasmids of CRKP enzyme type combinations reported in existing studies. Common combinations such as KPC + metalloenzyme, bimetallic enzyme, and metalloenzyme + OXA-48 are discussed in detail, including their genetic environments and transfer characteristics. Whole genome sequencing technology plays a crucial role in studying drug resistance genes of K. pneumoniae, facilitating in - depth identification and analysis of bacteria, and being useful for outbreak investigation and epidemiological surveillance. In conclusion, resistance genes in K. pneumoniae are often located on mobile elements. Different resistance genes tend to be carried by specific plasmids, which have high transformation rates and little impact on host growth. In order to prevent the emergence of Klebsiella pneumoniae carrying multiple drug-resistant genes, several measures such as the rational use of antibiotics, earlier monitoring of the transmission trajectory of strains, and the prediction of the development direction of drug resistance as much as possible are particularly important in the world today.
Keywords: Klebsiella pneumoniae, two carbapenemases, whole genome sequencing