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Genomic Insights Into Carbapenem‐Resistant Klebsiella pneumoniae in Pediatric Bloodstream Infections in Zhejiang, China (2019–2024)

Year: 2026

Type: article

Abstract: ABSTRACT Objectives Bloodstream infections (BSIs) caused by Klebsiella pneumoniae are associated with a significant risk of mortality. While the majority of existing research has concentrated on adult populations, there is a paucity of studies addressing pediatric cases. This study aims to elucidate the mechanisms underlying carbapenem resistance in K. pneumoniae strains responsible for bloodstream infections in children. Methods A retrospective study was conducted at Children's Hospital, Zhejiang University School of Medicine, focusing on patients diagnosed with bloodstream infections due to carbapenem‐resistant K. pneumoniae (CRKP). Antimicrobial susceptibility testing and whole‐genome sequencing were subsequently performed. Results In this study, all the CRKP‐BSI strains were detected during the COVID‐19 pandemic. The predominant mechanism of carbapenem resistance among the 10 CRKP‐BSI strains was the production of class B metallo‐beta‐lactamases, with bla NDM‐1 present in 50% of the strains, followed by bla NDM‐5 (30%) and bla IMP‐4 (20%). The ST25‐KL2 lineage was the most prevalent strain, with all isolates originating from the neonatal intensive care unit (NICU). In strain 22WJ8105, hypervirulence‐associated genes, including iucABC and iutA , were identified. Additionally, a strain of ST17‐type K. pneumoniae harboring the bla NDM‐5 gene was identified. Conclusions This study determined that the production of class B metalloenzymes is the primary mechanism of carbapenem resistance in pediatric bloodstream infections caused by CRKP. Importantly, the ST25‐KL2 lineage emerged as the dominant clone, highlighting its potential for nosocomial transmission.

Source: Journal of Clinical Laboratory Analysis

DOI: 10.1002/jcla.70232