analysis of the prevalence, drug resistance genes and evolution of carbapenem-resistant klebsiella pneumoniae in lishui, china from 2015 to 2024

Background: carbapenem-resistant klebsiella pneumoniae (crkp) is increasingly recognized as a significant global publichealth threat. however, comprehensive long-term epidemiological surveillance of clinical crkp isolates in china (lishui city) remains limited. objectives: to address this gap, we conducted a retrospective observational study spanning 2015 to 2024, aiming to evaluate the prevalence, drug resistance genes, and evolution of clinical crkp isolates. methods: clinical data and drug resistance profiles of crkp isolates from hospitalized patients were retrieved from medical records. antibiotic resistance genes were analyzed using whole-genome sequencing. fourier-transform infrared spectroscopy (ftir) was employed to examine the genetic evolution of the bacteria. results: a total of 6 676 k. pneumoniae strains were detected, including 714 crkp strains. the detection rate of crkp fluctuated from 9.77% in 2015 to a low of 3.00% in 2016, then increased to 10.38% in 2024. clinical risk factors for crkp included intensive care unit (icu) admission, hospitalization, and age over 60 years. all 25 crkp strains were identified as st11 type and carried bla kpc-2and bla shv enzyme genes. the ftir typing revealed that the predominant circulating strains from 2020 to 2024 belonged to the same clone. conclusions: the detection rate of crkp in our hospital has shown an increasing trend over the past decade. the bla kpc-2gene is the predominant drug resistance determinant in crkp, and horizontal transmission of the same clone is evident.