Genomic and clinical characterisation of multidrug-resistant carbapenemase-producing ST231 and ST16 Klebsiella pneumoniae isolates colonising patients at Siriraj hospital, Bangkok, Thailand from 2015 to 2017

Abstract Background Infections caused by carbapenemase-producing Enterobacteriaceae (CPE) have continually grown as a global public health threat, with significant mortality rates observed across the world. We examined clinical data from patients CPE infections and their outcomes, concentrating on Klebsiella pneumoniae isolates. analysed information, performed antimicrobial susceptibility testing, conducted molecular epidemiological genomic analyses isolates to identify patterns in data. Methods The characteristics of 33 hospitalised confirmed CPE, including patient-related factors associated development infections, were examined. Patients divided according whether they “colonised” or “infected” timing frequency rectal swab collections, which 45 swabs randomly selected for analysis. purified, tests performed. Whole genome sequences these determined compute bacterial multilocus sequence types plasmid replicon types, infer phylogenetic relationships, resistance virulence genes. Results Altogether, 88.9% (40/45) K. . most abundant carbapenemase gene family (33/39) was bla OXA-232 , NDM-1 additionally identified 19 them. All carrying either resistant meropenem, but only 40 susceptible colistin. Among CPE-infected ( n = 18) CPE-colonised who developed during study 3), all one received standard colistin-based combination therapy. Phylogenetic analysis revealed polyclonal spread (CPKP) within patient population, following two major subclades identified: ST16 15) ST231 14). CPKP-ST231 had highest score 4 primary bacteraemia. siderophores yersiniabactin aerobactin, considered be important factors, genomes. Conclusions This has features colonising isolates, focusing determinants. type multi-layered can further exploited Thailand elsewhere modify regimes used empirical antibiotic treatment improve management strategies patients.