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ORIGINAL RESEARCH article

Front. Microbiol.

Sec. Antimicrobials, Resistance and Chemotherapy

Volume 16 - 2025 | doi: 10.3389/fmicb.2025.1562222

Genomic analysis of carbapenem-resistant Klebsiella pneumoniae blood isolates from nationwide surveillance in South Korea

Provisionally accepted
Younggwon On Younggwon On JungWook Kim JungWook Kim Juyoung Lee Juyoung Lee Jung Sik Yoo Jung Sik Yoo *
  • Korea National Institute of Health, Cheongju-si, Republic of Korea

The final, formatted version of the article will be published soon.

    Introduction: Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a significant threat to public health owing to its multidrug resistance and rapid dissemination.This study analyzed CRKP isolates collected from bloodstream infections in nine regions of South Korea using the Kor-GLASS surveillance system between 2017 and 2021.Results: A total of 3,941 K. pneumoniae isolates were collected. Among them, 119 (3%) isolates were identified as CRKP. Most CRKP (79.7%) belonged to sequence type 307 (ST307), followed by ST11 (6.8%). All CRKP isolates exhibited multidrug resistance, with 78.8% carrying the IncX3 plasmid encoding the KPC-2 gene. Phylogenetic and genomic analyses revealed that ST307 isolates exhibited low single nucleotide polymorphism (SNP) differences.SNP differences among ST307 strains ranged from a minimum of 1 to a maximum of 140, indicating close genetic relatedness. All ST307 strains harbored the KL102 and O1/O2v2 loci, and genomic analysis revealed high prevalence of key resistance genes such as KPC (91.5%) and CTX-M-15 (83.9%), alongside mutations in the QRDR (ParC-80I, GyrA-83I) and ompK genes. Two major clusters were identified, with cluster 1 harboring yersiniabactin lineage 16 (ICEkp12) and cluster 2 showing higher virulence, including the yersiniabactin lineage 17 (ICEkp10) and colibactin-associated genes.Discussion: These findings underscore the dominance of ST307 among CRKP isolates in Korea, which is driven by clonal expansion and the critical role of mobile genetic elements. Therefore, enhanced genomic surveillance and targeted infection control measures are urgently required to address the spread of CRKP in clinical settings.

    Keywords: antibiotic resistance, whole genome sequence, national-wide, surveillance, Carbapenem, Genomic epidemiology

    Received: 17 Jan 2025; Accepted: 04 Apr 2025.

    Copyright: © 2025 On, Kim, Lee and Yoo. 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) or licensor 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.

    * Correspondence: Jung Sik Yoo, Korea National Institute of Health, Cheongju-si, Republic of Korea

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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