biostudies-literatureZhou KNational Natural Science Foundation of China2464https://www.ebi.ac.uk/biostudies/studies/S-EPMC10147710biostudies-literatureUnknown14(1)Adaptation to selective pressures is crucial for clinically important pathogens to establish epidemics, but the underlying evolutionary drivers remain poorly understood. The current epidemic of carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a significant threat to public health. In this study we analyzed the genome sequences of 794 CRKP bloodstream isolates collected in 40 hospitals in China between 2014 and 2019. We uncovered a subclonal replacement in the predominant clone ST11, where the previously prevalent subclone OL101:KL47 was replaced by O2v1:KL64 over time in a stepwise manner. O2v1:KL64 carried a higher load of mobile genetic elements, and a point mutation exclusively detected in the recC of O2v1:KL64 significantly promotes recombination proficiency. The epidemic succesNature communicationsA point mutation in recC associated with subclonal replacement of carbapenem-resistant Klebsiella pneumoniae ST11 in China.PMC10147710819020308217233081971984Hu SShen JDong YQuan BShen PMan SZhang LLuan LWang JWang LSun LWan CGuo LGu BLam MMCDong HWang SLiang JLiang KChen YKang JZhang BLiao ZLiao YXia XXu RQiao DChen FXu HJin YYang ZLi YLi ZHu HDu FXu TLin HBRICS Working GroupLiu JDing HMa LCao JWyres KLMao HLiu QDai YLiu YQi XWei SLiao GZheng LLi AZhou KXue CXXiao YZhou YYan XHuang YZhu LHolt KEZhu WLiu DfalseA point mutation in recC associated with subclonal replacement of carbapenem-resistant Klebsiella pneumoniae ST11 in China.Adaptation to selective pressures is crucial for clinically important pathogens to establish epidemics, but the underlying evolutionary drivers remain poorly understood. The current epidemic of carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a significant threat to public health. In this study we analyzed the genome sequences of 794 CRKP bloodstream isolates collected in 40 hospitals in China between 2014 and 2019. We uncovered a subclonal replacement in the predominant clone ST11, where the previously prevalent subclone OL101:KL47 was replaced by O2v1:KL64 over time in a stepwise manner. O2v1:KL64 carried a higher load of mobile genetic elements, and a point mutation exclusively detected in the recC of O2v1:KL64 significantly promotes recombination proficiency. The epidemic succes2023-01-01T00:00:00Z2023 Apr2026-04-30T12:32:32.82Z2024-11-12T07:05:48.483ZS-EPMC101477103711721710.1038/s41467-023-38061-z