LAUSR

ST11 carbapenem-resistant K. pneumoniae (CRKP) has been the dominant clone in China. In this review, we trace the prevalence of ST11 CRKP in China Antimicrobial Surveillance Network (CHINET), the key drug resistance mechanisms, and virulence evolution. The recent emergence of ST11 CR-hvKP strains in China attracts worldwide attention by acquiring a pLVPK-like virulence plasmid that such strains may cause severe infection in relatively healthy individuals that difficult to treat with current antibiotics. There is a very close linkage among IncF plasmids, NTEKPC, and ST11 Klebsiella pneumoniae in China. Hybrid conjugative virulence plasmids are demonstrated to readily convert an ST11 CRKP strain to a Hv-CRKP strain via conjugation. Understanding the molecular evolutionary mechanisms of resistance and virulence-bearing plasmids, the prevalence of ST11 CRKP in China allows improved tracking and control of such organisms.