Multicenter Study of Colistin Heteroresistance in Carbapenem-Resistant Klebsiella pneumoniae Strains in China

• DOI: 10.1128/spectrum.02218-22
• Publication Date: 2023-07-10T14:22:26Z
• Authors: Yuesong Weng; Tao Wang; Bin Huang; Hua Yu; Wei Jia; Bin Shan; Fen Qu; Yiwei Tang; Liang Chen; Hong Du
• Keywords: Colistin; Broth microdilution; Efflux; Carbapenem

Colistin has been considered a last-line option for the treatment of infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP). Heterogeneous resistance to colistin leads unexplained clinical failure CRKP. Our study aimed investigate extent heteroresistance among CRKP strains in China. A total 455 colistin-susceptible strains, collected from six tertiary care hospitals China, were characterized. The overall rate was 6.2%, as determined population analysis profiles (PAPs). Genomic revealed that 60.7% colistin-heteroresistant isolates belonged epidemic sequence type 11 (ST11) clone. Single-nucleotide polymorphisms (SNPs) suggested 6 ST5216 shared same origin. Each subpopulations had ≥8-fold decrease MIC presence carbonyl cyanide m-chlorophenylhydrazone (CCCP), which indicated could be suppressed an efflux pump inhibitor. In addition, our results PhoPQ pathway plays important role mechanisms heteroresistance. IMPORTANCE problem raised alarms concerning global health. enriches epidemiological where prevalence this phenomenon previously unknown. Importantly, may cause with colistin, even if laboratory reports are sensitive. commonly used broth microdilution method is unable detect special phenomenon. Additionally, indicate pumps play major heteroresistance, and inhibitors can effectively reverse it. first provide detailed well genetic