Clinical imipenem non-susceptible Klebsiella pneumoniae isolates from China: Epidemiology, molecular characterization and in vitro activity of imipenem/relebactam

Peiyao Jia; Pengcheng Li; Wei Yu; Xiaobing Chu; Hui Zhang; Jingjia Zhang; Wei Kang; Ge Zhang; Qian Zhang; Shiyu Chen; Yingchun Xu; Qiwen Yang

doi:10.1016/j.jgar.2025.05.011

Journal of Global Antimicrobial Resistance (Sep 2025)

Clinical imipenem non-susceptible Klebsiella pneumoniae isolates from China: Epidemiology, molecular characterization and in vitro activity of imipenem/relebactam

Peiyao Jia,
Pengcheng Li,
Wei Yu,
Xiaobing Chu,
Hui Zhang,
Jingjia Zhang,
Wei Kang,
Ge Zhang,
Qian Zhang,
Shiyu Chen,
Yingchun Xu,
Qiwen Yang

Affiliations

Peiyao Jia: Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Pengcheng Li: Value & Implementation, Global Medical & Scientific Affairs, MSD China, Shanghai, China
Wei Yu: Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
Xiaobing Chu: Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
Hui Zhang: Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Jingjia Zhang: Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Wei Kang: Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Ge Zhang: Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Qian Zhang: Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
Shiyu Chen: Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
Yingchun Xu: Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Qiwen Yang: Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Corresponding author. Mailing address. Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing Street, Beijing 100730, China.

DOI: https://doi.org/10.1016/j.jgar.2025.05.011
Journal volume & issue: Vol. 44
pp. 1 – 7

Abstract

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Objective: To describe the epidemiological and molecular characterization and in vitro activity of imipenem/relebactam against imipenem non-susceptible (IPMNS) Klebsiella pneumoniae isolates in China. Methods: K. pneumoniae isolates were collected from 16 sites in 5 regions across China during 2019. Antimicrobial susceptibility testing was performed. For IPMNS K. pneumoniae isolates, whole genome sequencing was used to screen for drug-resistance and virulence genes. Results: Of 1011 clinical K. pneumoniae isolates, 277 (27.3%) were IPMNS and were significantly more common in intensive care unit patients (47.5%) and hospital-acquired infections (28.9%). Production of carbapenemase was the dominant resistance mechanism, with 228 (89.8%) IPMNS isolates harbouring blaKPC-2, 8 (3.1%) blaNDM, 2 (0.8%) blaOXA-232 and 1 (0.4%) blaOXA-181. The dominant clone was sequence type (ST) 11 (78.7%) followed by ST15 (10.2%). Relebactam restored imipenem’s susceptibility in 96.5% isolates harbouring a blaKPC-2 gene. Conclusions: Harbouring the blaKPC-2 gene was the dominant mechanism of IPMNS K. pneumoniae in China. Empirical imipenem/relebactam treatment could be considered when susceptibility or carbapenemase tests are not available.

Published in Journal of Global Antimicrobial Resistance

ISSN: 2213-7165 (Print); 2213-7173 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Science: Microbiology
Website: https://www.journals.elsevier.com/journal-of-global-antimicrobial-resistance

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