High prevalence of KPC-2-producing hypervirulent Klebsiella pneumoniae causing meningitis in Eastern China

High prevalence of KPC-2-producing hypervirulent Klebsiella pneumoniae causing meningitis in Eastern China Min Xu,1,* Yiqi Fu,2,* Yunhui Fang,3 Hao Xu,3 Haishen Kong,3 Yanchao Liu,1 Yu Chen,1,3 Lanjuan Li3 1Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Center of Clinical Laboratory, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; 2Department of Respiratory Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; 3State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China *These authors contributed equally to this work Background: Klebsiella pneumoniae has been the leading causative pathogen for adult bacterial meningitis in several Asian countries. The clinical and microbiological characteristics of K. pneumoniae meningitis in mainland China are still unknown. Materials and methods: The clinical data of patients with K. pneumoniae meningitis from January 2011 to July 2017 in a tertiary hospital were retrospectively evaluated. The isolates were tested for antibiotic-resistance genes, virulence-associated genes, and molecular subtypes. Hypervirulent K. pneumoniae (hvKP) was defined as the presence of pLVPK-like virulence plasmid. Results: During the study period, a total of 48 patients with meningitis caused by K. pneumoniae were identified, accounting for 21.2% (48/226) of Gram-negative bacilli meningitis. Of the 44 available isolates, 65.9% (29/44) were carbapenem resistant, and all except one harbored blaKPC-2. K64 was the most common serotype (n