Emergence of ST11-K47 and ST11-K64 hypervirulent carbapenem-resistant in bacterial liver abscesses from China: a molecular, biological, and epidemiological study.

Multidrug-resistant bacteria, especially those with high virulence, are an emerging problem in clinical settings. We conducted a multicentre epidemiological and comparative genomic analysis on the evolution, virulence and antimicrobial resistance of carbapenem-resistant in patients with bacterial liver abscesses from 2012 to 2016. A total of 477 bacterial isolates were collected. were the main pathogen (89.3%) with (52.4%) predominating followed by (26.8%). All CRKps (3.2%) were of sequence type (ST) 11 and serotypes K47 or K64, and simultaneously possessed acquired / and together with the multidrug transporter EmrE. Seven Hv-CRKps (five ST11-K47, two ST11-K64) were confirmed by bacteriological test, neutrophil killing assay and infection model. Genomic analysis indicated that the emergence of one ST11-K64 Hv-CRKp strain was related to the acquisition of genes and siderophore gene clusters, while ST11-K47 Hv-CRKp lacked these traditional virulence genes. Further complete genome analysis of one ST11-K47 Hv-CRKp strain, R16, showed that it acquired a rare plasmid (pR16-Hv-CRKp1) carrying , , , , and a predicted virulence gene R16_5486 simultaneously. The emergence of the ST11-K47/K64 Hv-CRKps, which are simultaneously multidrug-resistant and hypervirulent, requires urgent control measures to be implemented.