Emergence of KPC-2 and NDM-13-coproducing carbapenem-resistant hypervirulent Klebsiella pneumoniae with high-risk sequence type ST11 - Original Research

Sep 28, 2026

Carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKp) co-producing KPC and NDM threatens public health. This study investigates a clinical CR-hvKP isolate from China that coproduces KPC-2 and NDM-13, focusing on the molecular determinants of antibiotic resistance and virulence. Using MALDI-TOF/MS, susceptibility testing, whole-genome sequencing, conjugation and plasmid stability assays, along with serum-killing experiments, the work links resistance genes and virulence factors to specific plasmids and chromosome locations. Findings support the need for enhanced surveillance to limit dissemination.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Introduction

Methods

Antimicrobial testing and identification

Genomic and plasmid characterization

Virulence assessment

Results

Conclusion

TYPE Original Research PUBLISHED 17 December 2025 DOI 10.3389/fmicb.2025.1683102 OPEN ACCESS EDITED BY Karsten Becker, University Medicine Greifswald, Germany REVIEWED BY Costas C. Papagiannitsis, University of Thessaly, Greece Anahit Sedrakyan, Institute of Molecular Biology (IMB), Armenia *CORRESPONDENCE Gang Li [gone.lee@163.com](gone.lee@163.com)[ ](gone.lee@163.com)Jia Tao [taojia19880625@163.com](taojia19880625@163.com) †These authors have contributed equally to this work RECEIVED 12 August 2025 REVISED 22 November 2025 ACCEPTED 25 November 2025 PUBLISHED 17 December 2025 CITATION Tao J, Wang L, Yang N, Fu H, Hu X, Lai T, Jin J and Li G (2025) Emergence of KPC-2 and NDM-13-coproducing carbapenem-resistant hypervirulent Klebsiella pneumoniae with high-risk sequence type ST11 . Front. Microbiol. 16:1683102 . doi: 10.3389/fmicb.2025.1683102 COPYRIGHT © 2025 Tao, Wang, Yang, Fu, Hu, Lai, Jin and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Emergence of KPC-2 and NDM-13-coproducing carbapenem-resistant hypervirulent Klebsiella pneumoniae with high-risk sequence type ST11 Jia Tao 1,2*, Liru Wang 1,2†, Na Yang 2, Hui Fu 1,2†, Xinxin Hu3,4, Tingyu Lai 5, Jianning Jin3† and Gang Li 1,2* 1Center of Medical Laboratory, General Hospital of Ningxia Medical University, Yinchuan, China, 2Ningxia Key Laboratory of Clinical and Pathogenic Microbiology, General Hospital of Ningxia Medical University, Yinchuan, China, 3Traditional Chinese Medicine Department, General Hospital of Ningxia Medical University, Yinchuan, China, 4The First Clinical Medical College, Ningxia Medical University, Yinchuan, China, 5School of Laboratory Medicine, Ningxia Medical University, Yinchuan, China Background: Carbapenem-resistant hypervirulent Klebsiella pneumoniae (CRhvKp) co-producing KPC and NDM poses serious threats to public health. This study aimed to elucidate the molecular mechanisms underlying the resistance and virulence of a clinical CR-hvKP isolate coproducing KPC-2 and NDM-13 in China. Methods: The K. pneumoniae strain A51998714 was isolated from a 58-yearold male patient in China in June 2024. MALDI-TOF/MS was used to species identity. Antimicrobial susceptibility testing was determined using the VITEK-2 system. Whole-genome sequencing (WGS), plasmid conjugation assays, and plasmid stability testing were conducted to characterize resistance and virulence determinants. Virulence potential was assessed using serum-killing assays. Results: The CR-hvKp strain A51198714 exhibited resistance to nearly all tested antibiotics, including ceftazidime-avibactam and aztreonam. PCR and Sanger sequencing confirmed the co-occurrence of blaKPC-2 and blaNDM-13. WGS analysis revealed that strain A51198714, belonging to ST11-K64, possessed a single chromosome and five plasmids. Virulence-associated genes, localized on the IncHI1Bplasmid pA51998714-VIRand the chromosome, were linked to enhanced colonization and infectivity. The serum-killing assay showed strain A51998714 was resistant to serum killing. The blaKPC-2, blaCTX-M-65, and blaTEM-1 genes were located on an IncFII plasmid pA51998714-KPC. The blaNDM-13 gene was located on plasmid pA51998714-NDM, which was classified as IncI1-I type. Conjugation assay and plasmid stability testing showed that plasmid pA51998714-NDM can be successfully transferred and maintained stably in the host. Conclusion: This study reports a clinical ST11-K64 CR-hvKP strain co-producing KPC-2 and NDM-13, which carried multiple resistance genes on two resistant plasmids, along

FAQs

What clinical isolate and resistance profile were examined in this study?

The study examined a K. pneumoniae isolate (A51998714) from a 58-year-old male in China. It showed resistance to nearly all tested antibiotics, including ceftazidime-avibactam and aztreonam.

How were KPC-2 and NDM-13 identified in the isolate?

PCR and Sanger sequencing confirmed the co-occurrence of blaKPC-2 and blaNDM-13. Whole-genome sequencing further mapped these genes to specific plasmids and genomic regions.

What evidence indicates the isolate had virulence potential despite serum killing resistance?

Virulence-associated genes were located on the IncHI1B plasmid pA51998714-VIR and the chromosome, and were linked to enhanced colonization and infectivity. In addition, the serum-killing assay showed resistance to serum killing.

Sep 28, 2026

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