We report a case of a Chinese male patient with a history of Hepatolithiasis who was admitted for abdominal pain, fever, and chills. Imaging studies suggested cholangitis and Hepatolithiasis. Blood cultures revealed two rare fastidious anaerobes-Olsenella uli and Christensenella hongkongensis-confirmed by MALDI-TOF MS and 16S rDNA full-length sequencing. These organisms failed to grow on standard solid media but were successfully isolated using a self-prepared solid medium formulated based on the nutrient solution from blood culture bottles. This suggests that for anaerobic bacteria with positive blood cultures but negative routine cultures, the use of such media may improve isolation rates. This case demonstrates that although such infections are extremely rare, mortality may correlate with the severity of underlying disease. Successful identification provides a reference method for isolating and identifying fastidious bacteria in similar cases.

IntroductionAntibiotic heteroresistance challenges clinical treatment, risking adverse outcomes and antimicrobial resistance emergence. This study aims to explore its research status and trends.MethodsWe screened global publications on antibiotic heteroresistance from the Web of Science Core Collection, Scopus and PubMed databases. Bibliometrix and VOSviewer were used to conduct the bibliometric and visual analysis of the publications.ResultsIn total, 1516 publications on antibiotic heteroresistance were included. The number of publications and citations increased with time, most notably in the last two decades. Among the 377 sources, the most active and most cited journal was Antimicrobial Agents and Chemotherapy. The most productive and most cited author were Michael J. Rybak and Keiichi Hiramatsu, respectively.Emory University and Monash University were the institutions with the most publications and citations, respectively. The USA had the highest publications and citations. Emory University and Monash University were the institutions with the most publications and citations, respectively. The USA had the highest publications and citations. A total of 1758 author keywords and five main clusters were identified, including heteroresistance terms cluster, Gram-positive bacteria cluster, Gram-negative bacteria cluster, Mycobacterium tuberculosis cluster and antifungal heteroresistance cluster. The top ten antibiotics and microorganisms with keywords co-occurrence frequency were colistin, vancomycin, polymyxins, daptomycin, rifampin, fluconazole, fluoroquinolones, linezolid, tigecycline, clarithromycin, MRSA, Staphylococcus aureus, hVISA, Acinetobacter baumannii, Mycobacterium tuberculosis, Helicobacter pylori, Klebsiella pneumoniae, VISA, Pseudomonas aeruginosa, Staphylococcus.ConclusionFindings reveal global trends and research profiles of antibiotic heteroresistance. Useful for researchers, microbiologists, and clinicians to understand the field and guide future studies.

This study aimed to investigate the molecular basis of polymyxin B resistance in clinical carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates. A total of 52 polymyxin B-resistant CRKP clinical isolates were collected at West China Hospital between 2018 and 2021. Polymyxin B susceptibility testing was performed using the broth microdilution method. Whole-genome sequencing was conducted to determine sequence types (STs), capsular loci, resistance genes, virulence genes and mutations in genes associated with polymyxin B resistance. Transcriptome sequencing was used to compare changes in gene expression between selected high-minimum inhibitory concentration (MIC) isolates after polymyxin B exposure and controls cultured without polymyxin B. The majority (98.08

Cryptococcus neoformans is the leading cause of fungal meningoencephalitis. Cellular heterogeneity during cryptococcal infection contributes to host adaptation and fungal pathogenesis. C. neoformans titan cells and seed cells represent enlarged and small-sized morphotypes, respectively, which exhibit distinct transcriptional profiles and can be induced by environmental factors. In this work, we describe a distinct small morphotype of C. neoformans , referred to as ovoid cells. The formation of ovoid cells is promoted by host-related conditions such as nutrient limitation and elevated CO 2 levels, which was observed during the late stage of cryptococcal infection. In addition to their smaller size compared to typical yeast cells, ovoid cells highly express OSP1 , a marker distinguishes ovoid cells from other small morphotypes, including seed cells and titanides. These cells exhibit an increased budding and proliferation rate, which is consistent with transcriptome data that ovoid cells upregulate cell cycle related genes. We further demonstrate that the glucose repression signaling pathway and the cAMP/PKA pathway are involved in ovoid cell formation in C. neoformans . Ovoid cells show reduced fungal virulence but enhanced tolerance under long-term fluconazole treatment, indicating their important role in the balancing virulence and antifungal tolerance within C. neoformans populations.

BACKGROUND:Bloodstream infection (BSI) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) is a serious and urgent threat for hospitalized patients. This study aims to describe the clinical and molecular characteristics of CRKP causing BSI in a tertiary care hospital in Chengdu, China. METHODS:In total, 123 nonconsecutive CRKP strains were collected in the hospital from 2020 to 2022 and sent for whole genome sequencing. String tests were performed of all CRKP strains, and clinical information of relevant cases was collected. RESULTS:Among the 123 CRKP strains collected, the median age of the patients was 53 years, 77.2% of patients with CRKP BSI were elderly men, 62.6% were admitted to the intensive care unit, 80.5% underwent intravascular catheters procedures, and 86.7% had underlying lung diseases. The rate of 30-day mortality was 21.1%. Microbiological characteristics showed that carbapenem resistance was primarily mediated by carbapenemase acquisition, predominantly blaKPC-2 (93.5%). The 123 CRKP isolates comprised 9 sequence types (STs) and 10 serotypes, with ST11 being dominant (84.6%). The serotype KL64 accounted for 73.2%, followed by KL47 at 7.3%. The positive rate of the string test was 13.8%, and virulence genes (rmpA2, iuc-iutA) were detected in 48.8% of ST11-KL64 strains. Phylogenetic analysis indicated that most ST11 strains were closely related. Genomic transmission analyses revealed that 6.7% of pairs had ≤20 pairwise single-nucleotide polymorphisms and were thus designated as "highly likely" transmission. CONCLUSIONS:This study poses an urgent need for enhancing infection control measures in the hospital, especially CRKP strains with hypervirulent genes.

OBJECTIVES:To evaluate the efficacy of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS)-based antifungal susceptibility testing (MS-AFST) for rapid detection of fluconazole resistance in Candida tropicalis. METHODS:C. tropicalis isolates from patients with bloodstream infections at West China Hospital of Sichuan University (2018-2023) were collected and identified by chromogenic culture and MALDI-TOF MS. Using Clinical and Laboratory Standards Institute broth microdilution (BMD) method as the reference standard, we compared the performance of the Sensititre YeastOne chromogenic antifungal susceptibility testing and optimized MS-AFST based on the minimum profile change concentration (MPCC). RESULTS:All the 41 isolates were confirmed as C. tropicalis, which showed an azole resistance rate of 36.59% and a proportion of non-wild-type strain of 68.29% with high cross-resistance to azoles. The categorical agreement (CA) and essential agreement (EA) between Sensititre YeastOne and CLSI BMD were both 100%, and their minimum inhibitory concentrations were highly correlated. The MPCC-based MS-AFST enabled rapid detection of fluconazole-resistant phenotype of C. tropicalis within approximately 3 h, demonstrating a CA of 92.68% and an EA of 90.24% both in comparison with the CLSI BMD reference method and Sensititre YeastOne; very major error\discrepancy occurred in two strains, and minor error\discrepancy occurred in one strain. CONCLUSIONS:MPCC-based MS-AFST enables rapid, reliable detection of fluconazole resistance in C. tropicalis with good agreement with the reference methods. However, classification errors remain, which should be improved by further technical optimization of this method and exploration of the underlying molecular mechanisms.

OBJECTIVES:Community-acquired and hospital-acquired bloodstream infections (CA-BSI and HA-BSI) caused by Gram-negative bacteria (GNB) pose major clinical risks, but differences in their molecular epidemiology and prognostic etiologic factors remain unclear. METHODS:A genomic epidemiology study analyzed 933 CA-BSI and 1001 HA-BSI isolates from 21 major Chinese teaching hospitals. We collected comprehensive clinical data and conducted molecular characterization, including sequence types, antibiotic resistance genes, virulence factors, and plasmid types, as well as clinical phenotypes of major pathogens. Multivariable Cox models were used to identify mortality predictors. RESULTS:Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacter cloacae complex were the predominant species in both CA-BSI and HA-BSI groups but exhibited distinct clinical and molecular characteristics between CA-BSI and HA-BSI. CA-BSI patients showed significantly higher inflammatory markers (CRP, PCT, WBC, and Neu%), while HA-BSI patients had significantly poorer prognosis including prolonged hospitalization, higher ICU admission rates and clinical deterioration or mortality. Genomic surveillance revealed a critical divergence: HA isolates were dominated by high-risk clones such as ST11 K. pneumoniae and ST2 A. baumannii, which were enriched in antimicrobial resistance genes, directly linking to worse outcomes. CA isolates, while more diverse, were characterized by specific lineages including ST131 E. coli (enriched with specific virulence genes: yersiniabactin, K1 capsule, and P fimbriae) and ST23 K. pneumoniae, which carried a significantly greater number of virulence genes. Multivariable analysis confirmed that mortality risk profiles are setting-specific, influenced by distinct combinations of patient comorbidities (including age, gender, agranulocytosis, and infection source) and bacterial genetic determinants (such as lacI or aadA2 for K. pneumoniae and aph(3')-Ia for A. baumannii). CONCLUSIONS:This first genomic epidemiological investigation of GNB-BSIs stratified by acquisition setting reveals a fundamental clinical and epidemiological divergence between CA- and HA-cases. The study underscores that tracking mortality-associated strains and genes is essential for improving clinical outcomes and advancing etiological knowledge.

Pleurostoma species are rare opportunistic fungal pathogens that primarily infects immunocompromised hosts, causing phaeohyphomycosis, manifesting as localised superficial or deep infections, pulmonary infections, central nervous system infections, or disseminated diseases. Fungi of the order Mucorales are known to cause rapidly progressive infections in the lungs, rhino-orbital-cerebral regions, and skin, with high mortality rates. We report the first case of rhino-orbital co-infection by these pathogens in a diabetic patient, resulting in irreversible vision loss. The patient presented with headache and facial swelling; imaging and endoscopy revealed sinus disease with purulent discharge. Following endoscopic sinus debridement, laboratory diagnosis was confirmed by integrating microscopic staining, fungal culture, and PCR. While early surgical intervention combined with amphotericin B therapy led to clinical improvement, the vision loss persisted. This case underscores the diagnostic challenges of rare fungal co-infections and emphasises the necessity of prompt combined surgical and antifungal intervention to improve outcomes.

OBJECTIVES:To investigate the epidemiology and molecular typing of 307 clinical Wickerhamomyces anomalus isolates collected in China. METHODS:A total of 307 W. anomalus isolates were collected from CHIF-NET, a surveillance network with nationwide coverage, from 2009 to 2021. Antifungal susceptibility of all W. anomalus isolates were tested by broth microdilution according to CLSI methods. Genotyping of all isolates was performed using a panel of polymorphic microsatellite markers. RESULTS:The number of W. anomalus isolates was highest in Northeast China, with 121 strains, accounting for 4.6% of the total Candida spp. isolates in the region. Newborns emerged as the primary community of infection, with 84 isolates (12.7% of all Candida spp. in the newborn group). Most W. anomalus isolates were recovered from blood samples (249 isolates). The isolates were found to exhibit notable ratios of non-wild type to fluconazole and voriconazole (48.5% and 34.5%). A total of 118 microsatellite-based types were identified among a set of 309 isolates that included the 307 clinical isolates along with reference strains ATCC 8168 and CICC 32553. This analysis revealed potential nosocomial outbreaks. CONCLUSIONS:Our research is the largest investigation of W. anomalus drug susceptibility thus far, providing foundational data that could contribute to future establishment of resistance breakpoints and enhancing epidemiological surveillance capabilities. Our study suggests the importance of nosocomial surveillance and drug resistance management for W. anomalus.

The study aims were to present in vitro susceptibilities of clinical isolates from Gram-negative bacteria bloodstream infections (GNBSI) collected in China. GNBSI isolates were collected from 18 tertiary hospitals in 7 regions of China from 2018 to 2020. Minimum inhibitory concentrations were assessed using a Trek Diagnostic System. Susceptibility was determined using CLSI broth microdilution, and breakpoints were interpreted using CLSI M100 (2021). A total of 1,815 GNBSI strains were collected, with E. coli (42.4%) and Klebsiella pneumoniae (28.6%) being the most prevalent species, followed by P. aeruginosa (6.7%). Susceptibility analyses revealed low susceptibilities (<40%) of ESBL-producing E. coli and K. pneumonia to third-/fourth-generation cephalosporins, monobactamases, and fluoroquinolones. High susceptibilities to colistin (95.0%) and amikacin (81.3%) were found for K. pneumoniae , while Acinetobacter baumannii exhibited a high susceptibility (99.2%) to colistin but a low susceptibility to other antimicrobials (<27.5%). Isolates from ICUs displayed lower drug susceptibility rates of K. pneumoniae and A. baumannii than isolates from non-ICUs (all P < 0.05). Carbapenem-resistant and ESBL-producing K. pneumoniae detection was different across regions (both P < 0.05). E. coli and K. pneumoniae were major contributors to GNBSI, while A. baumannii exhibited severe drug resistance in isolates obtained from ICU departments.

This study investigated the clinical and molecular characteristics of Staphylococcus aureus (S. aureus) isolates from patients with coronavirus disease 19 (COVID- 19) at West China Hospital between December 1, 2022 and January 31, 2023. In total, 102 strains isolated from sputum, bronchoalveolar lavage fluid, endotracheal aspirates, and blood were collected from 102 patients and subjected to multilocus sequence typing and antimicrobial susceptibility testing. Eighteen virulence genes were also analyzed by polymerase chain reaction. Seventy-five patients were discharged and 27 died. The predominant comorbidities were hypertension, diabetes mellitus, and cardiac disease. Twenty-eight known sequence types (STs) and 10 novel ones (ST8773/CC398, ST9221/CC5, ST9222/CC59, ST9223/CC8, ST9224/CC22, ST9225/CC1, ST9226/CC5, ST9227/CC59, ST9228/CC59, ST9229/CC398) were identified. The dominant molecular types were ST15 (CC15), ST59 (CC59), and ST5 (CC5). Among the three most prevalent STs, ST5 was significantly more resistant to levofloxacin, moxifloxacin, ciprofloxacin, and sulfamethoxazole than were ST59 and ST15. ST59 and ST5 had higher rates of resistance to erythromycin and clindamycin than ST15. All isolates contained at least eight virulence genes. The hemolysin gene hlb was found to be more prevalent in ST59 (100

Background:The rising global burden of invasive fungal infections and the growing issue of antifungal resistance present critical public health threats. By using multicenter surveillance data from Sichuan Province, we conducted the largest five-year study on fungemia to date. Our objective was to gain insights into regional differences in the distribution and resistance patterns of fungal pathogens. Methods:We performed a retrospective analysis of fungal bloodstream infections (BSIs) from 31 hospitals (2019-2023). Integrated clinical and laboratory data were analyzed using WHONET 5.6 to assess resistance patterns, and Microsoft Excel (with PivotTable functionality) was used to analyze epidemiological trends. Results:Annual fungal isolations increased steadily over the study period. Candida species accounted for 88.7% (1,805/2,034) of the bloodstream isolates, with C. albicans being the most common (38.4%, 694/1,805). The majority of patients were men (58.6%, 1,191/2,034) and aged 46 years or older (80.0%, 1,627/2,034). Intensive care unit (ICU) cases accounted for 36.8% (748/2,034) of the total. C. albicans showed the highest fluconazole susceptibility (91.2%, 633/694). Both C. albicans and the C. parapsilosis complex maintained >80% voriconazole susceptibility, followed by the voriconazole wild-type C. glabrata complex (69.3%). C. tropicalis exhibited high resistance to fluconazole (36.2%, 21/58) and voriconazole (34.8%, 20/58). Cryptococcus spp. displayed non-wild-type rates to amphotericin B (8.7%), flucytosine (5.8%), fluconazole (8.7%), voriconazole (8.0%), and itraconazole (4.1%). Different hospital types isolated varying fungal species. While C. albicans was the predominant species in 83.9% (26/31) of the hospitals, pediatric specialty centers exhibited distinct microbiological profiles, showing the highest isolation rates of the C. parapsilosis complex (χ2 = 18.34, p = 0.002). Conclusion:Our research conducted across several centers, revealed significant geographic variations in the spread of fungal diseases and antifungal resistance. It is important to understand local epidemiology to guide antifungal therapy and enhance stewardship programs.

Objective:To analyze the molecular epidemiology of Candida tropicalis (C. tropicalis) isolates from bloodstream infections, and to investigate preliminarily the underlying mechanisms of fluconazole resistance. Methods:Clinical C. tropicalis isolates were collected from bloodstream infections at West China Hospital, Sichuan University and other hospitals in Sichuan Province. All the collected isolates were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and the antifungal susceptibility test was performed by the broth microdilution method. Multilocus sequence typing (MLST) was conducted using the first generation sequencing technique. Genes associated with drug-resistance were sequenced and the mutation sites were identified. The relative expression levels of genes associated with drug-resistance were analyzed using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Results:A total of 39 C. tropicalis isolates from bloodstream infections were collected. The MLST phylogenetic tree showed that most of the strains clustered in the phylogenetic tree shared identical or similar minimal inhibitory concentrations (MICs). All MLST types were not matched with the isolates in the PubMLST database, representing new diploid sequence types (DSTs). A total of 3 sense mutations, including Ser154Phe, Tyr132Phe, and Tyr257His were identified in ERG11, and were present only in drug-resistant strains. UPC2 contained 4 sense mutations, including Ala251Thr, Gln289Leu, Ser279Glu, and Gln313His, which were also present only in drug-resistant strains. Ser279Glu and Gln313His were previously unreported. There were two sense mutations in ERG3, namely Ser112Gly and Ala48Ser, both being previously unreported, and Ser112Gly was found only in drug-resistant strains. The expression levels of ERG11 (14.48 vs 7.109, P = 0.003) and UPC2 (1.922 vs 0.832, P = 0.04) in non-sensitive group (MIC > 2 mg/L) were higher than those in sensitive group (MIC ≤ 2 mg/L), and the difference was statistically significant. Conclusion:There may be a unique genetic relationship among C. tropicalis isolates from Sichuan province, and the MICs of fluconazole against C. tropicalis are associated with molecular typing. ERG11 mutations were the major mechanism underlying fluconazole resistance in C. tropicalis isolates. The upregulation of ERG11 and UPC2 was associated with fluconazole resistance in C. tropicalis.

BACKGROUND:Listeria monocytogenes is one of the major bacteria responsible for meningitis. Controversy exists regarding the neuropathological effect of human pegivirus-1 (HPgV-1). Whether HPgV-1 interacts with L. monocytogenes is unknown. Herein, we describe a multiple myeloma patient with disseminated L. monocytogenes and HPgV-1 coinfection. CASE PRESENTATION:The case of a 57-year-old patient with fever accompanied by headache, dizziness, nausea, vomiting of stomach contents, and urinary and faecal incontinence is presented. Through metagenomic next-generation sequencing and the detection of L. monocytogenes and HPgV-1 in cerebrospinal fluid, along with blood culture of L. monocytogenes and PCR of HPgV-1 in the blood, a diagnosis of HPgV-1 and L. monocytogenes meningitis, HPgV-1 viremia, and L. monocytogenes sepsis was made, enabling timely and proper treatment with meropenem. After treatment, the patient recovered and was discharged from the hospital. CONCLUSIONS:To our knowledge, this is the first reported case of disseminated L. monocytogenes and HPgV-1 coinfection. Determining whether HPgV-1 was responsible for meningitis will require further research, including histopathological analysis.

Objective: Ceftazidime-avibactam (CZA) is a novel beta-lactam/ beta-lactamase inhibitor with activity against carbapenem-resistant Klebsiella pneumoniae (CRKP) that produce Klebsiella pneumoniae carbapenemase (KPC). In this study, we report the first cases of CZA resistance to develop during treatment of CRKP infections and identify the resistance mechanism. Methods: APB/EDTA and NG-Test CARBA5 were used to detect the production of carbapenemase, whole-genome sequencing (WGS) and conjugation experiment were used to identify potential resistance mechanisms of CZA-susceptible (HX1032) and- resistant (HX1192) K. pneumoniae isolates. Results: HX1192 K. pneumoniae was not recognized by APB/EDTA and NG-Test CARBA5 phenotypic assays, WGS revealed it carrying a novel KPC variant, KPC-179, molecular analysis highlighted a G394A mutation, and an ATC insertion at 543 in the bla KPC-2 gene, resulting in an A133T substitution and insertion of the amino acid S at Ambler position 183 in the protein sequence. Remarkably, this mutation restored susceptibility of imipenem (MIC = 0.25 mg/L). Conclusion: Our study highlights the importance of monitoring susceptibility during CZA treatment and accurately detecting KPC variants.

Background: Currently, EUCAST have issued guidelines for direct rapid antimicrobial susceptibility testing (RAST) on blood cultures. There were few reports on total laboratory automation (TLA) for RAST in China. Additionally, certain antibiotic discs used in China with specific concentrations lack EUCAST breakpoints. The purpose of this study is to use TLA to evaluate EUCAST RAST methods in Enterobacterales-containing blood cultures and to investigate the optimal breakpoints for a selection of antibiotics, including cefepime (EFP), cefotaxime (CTX), ceftazidime (CAZ), piperacillin-tazobactam (TZP), and cefoperazone/sulbactam (CSL). Methods: From April to August 2022, blood cultures positive for Enterobacterales (54 Escherichia coli and 60 Klebsiella pneumoniae) were analyzed. EUCAST RAST (4h, 6h, 8h) were performed using TLA and compared with Vitek 2 results. Results: EUCAST RAST's readable inhibition zone increased over time, with high categorical agreement with Vitek 2 (97.1%, 96.2%, 96.1% for E. coli , and 96.1%, 97.1%, 97.9% for K. pneumoniae) and low error rates. Based on the optimal breakpoints we defined, the categorical agreement for EFP, CTX, CAZ, and TZP against E. coli was greater than 90% at both 6 and 8 hours. However, the categorical agreement for CSL was 57.1% at 6 hours and 74.3% at 8 hours, primarily due to a higher proportion of minor errors (42.9% and 25.7%, respectively). For K. pneumoniae, the categorical agreement for all five antibiotics was greater than 90% at both time points. Conclusion: According to the CLSI-M52 standards, the detection performance of EUCAST RAST at 4h, 6h, and 8h was equivalent to that of Vitek 2. Except for ciprofloxacin in E. coli, the readable rates and categorical agreement of all antibiotics are good at 6h. For the optimal breakpoints we have established, all antibiotics except for CSL against E. coli achieve a categorical agreement of over 90%.

Invasive diseases caused by the globally distributed commensal yeast Candida tropicalis are associated with mortality rates of greater than 50%. Notable increases of azole resistance have been observed in this species, particularly within Asia-Pacific regions. Here, we carried out a genetic population study on 1571 global C. tropicalis isolates using multilocus sequence typing (MLST). In addition, whole-genome sequencing (WGS) analysis was conducted on 629 of these strains, comprising 448 clinical invasive strains obtained in this study and 181 genomes sourced from public databases. We found that MLST clade 4 is the predominant azole-resistant clone. WGS analyses demonstrated that dramatically increasing rates of azole resistance are associated with a rapid expansion of cluster AZR, a sublineage of clade 4. Cluster AZR isolates exhibited a distinct high-level azole resistance, which was induced by tandem duplications of the ERG11 A395T gene allele. Ty3/gypsy -like retrotransposons were found to be highly enriched in this population. The alarming expansion of C. tropicalis cluster AZR population underscores the urgent need for strategies against growing threats of antifungal resistance.

Objective:To investigate the clinical characteristics and molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolated from patients with bloodstream infections in a large tertiary-care general hospital in Southwest China.Methods:A total of 131 strains of non-repeating CRKP were collected from the blood cultures of patients who had bloodstream infections in 2015-2019. The strains were identified by VITEK-2, a fully automated microbial analyzer, and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry. The minimum inhibitory concentration (MIC) was determined by microbroth dilution method. The common carbapenemase resistant genes and virulence factors were identified by PCR. Homology analysis was performed by multilocus sequencing typing. Whole genome sequencing was performed to analyze the genomic characteristics of CRKP without carbapenemase.Results:The 131 strains of CRKP showed resistance to common antibiotics, except for polymyxin B (1.6% resistance rate) and tigacycline (8.0% resistance rate). A total of 105 (80.2%) CRKP strains carried the Klebsiella pneumoniae carbapenemase (KPC) resistance gene, 15 (11.4%) strains carried the New Delhi Metallo-β-lactamase (NDM) gene, and 4 (3.1%) isolates carried both KPC and NDM genes. Sequence typing (ST) 11 (74.0%) was the dominant sequence type. High detection rates for mrkD (96.2%), fimH (98.5%), entB (100%), and other virulence genes were reported. One hypervirulent CRKP strain was detected. The seven strains of CRKP that did not produce carbapenemase were shown to carry ESBL or AmpC genes and had anomalies in membrane porins OMPK35 and OMPK36, according to whole genome sequencing.Conclusion:In a large-scale tertiary-care general hospital, CRKP mainly carries the KPC gene, has a high drug resistance rate to a variety of antibiotics, and possesses multiple virulence genes. Attention should be paid to CRKP strains with high virulence.