| Title: |
Short-Term Within-Host Genomic Diversity and Clone Turnover of Carbapenem-Resistant Klebsiella pneumoniae in an Intensive Care Unit Patient. |
| Authors: |
Mikhaylova, Yulia; Slavokhotova, Anna; Ni, Oksana; Protsenko, Denis; Bruskin, Sergey; Shelenkov, Andrey; Akimkin, Vasiliy |
| Source: |
Antibiotics (2079-6382); Jun2026, Vol. 15 Issue 6, p605, 16p |
| Subject Terms: |
Carbapenem-resistant bacteria; Whole genome sequencing; Genetic variation; Intensive care units; Plasmid genetics; Microbial diversity; Microevolution; Drug resistance in bacteria |
| Abstract: |
Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a critical public health threat because infections caused by this pathogen are associated with high morbidity, mortality, and limited effective therapeutic options. Whilst the majority of studies have concentrated on inter-patient bacterial transmission, within-host genomic analysis offers unprecedented resolution for tracking dynamic clone predominance, plasmid rearrangements, and microevolution under clinical selection pressures. Methods and Results: Whole-genome sequencing (WGS) of nine isolates recovered from oral and rectal swabs revealed an exceptional case of CRKP clonal turnover in an intensive care unit (ICU) patient. Three distinct high-risk clones were identified during the 18 days of surveillance: an initial ST101 (Clonal Group (CG) 101) strain (days 1–7) followed by concurrent colonization with ST395 (carrying blaNDM-5) and ST512 lineages (both CG258, days 11–18). Conclusions: This study describes a rare instance of within-host heterogeneity of CRKP, involving three distinct STs spanning two CGs. Whole-genome analysis revealed potential structural rearrangements of resistance- and virulence-associated plasmids between coexisting lineages. These genomic shifts likely reflect rapid adaptation under the intense selective pressure of broad-spectrum antibiotic therapy, culminating in the persistence of a less virulent yet multidrug-resistant ST512 clone and a favorable clinical outcome with patient recovery. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |