Prevalence and global distribution of blaKPC-2 and blaNDM-1 genes in Klebsiella Pneumoniae

Carbapene-resistant Klebsiella pneumoniae infections have caused a major concern and posed a global health threat to public. blaKPC-2 and blaNDM-1 genes are the most widely reported of carbapenem resistance genes in K. pneumoniae. In this study, we investigated phylogenetic relationships of carbapene-resistant K. pneumoniae from a tertiary hospital between 2013 and 2018 in China and analyzed the global epidemiology and distribution of blaKPC-2 and blaNDM-1 gene in K. pneumoniae based on 1579 NGS genomes. We found that 19 carbapene-resistant K. pneumoniae isolated were divided into five lineages and all had high genotypic and phenotypic resistance. Two lineages (mostly ST11 and ST25) were the major type detected carrying blaKPC-2 and blaNDM-1 gene, respectively. Among global genomes data, 147 known ST types have been identified and ST11 and ST258 were the globally prevalent clones. Genetic environment analysis showed that the ISKpn27-blaKPC-2-ISKpn6 and blaNDM-1-ble-trpf-nagA may be the core structure in the horizontal transfer of blaKPC-2 and blaNDM-1, respectively. In addition, DNA transferase (hin) may be involved in the horizontal transfer or the expression of blaNDM-1. This study sheds some light on the genetic environment of blaKPC-2 and blaNDM-1 and should foster further studies about the mechanism of carbapene-resistant K. pneumoniae dissemination.