Zhao Y, Zhang S, Fang R, et al. - Researchers further studied 214 carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates identified among a total of 2,299 K. pneumoniae clinical strains collected from a major Eastern Chinese medical center during 2003– 2016 in order to determine transitions in resistance mechanisms, virulence characteristics and molecular epidemiology of CRKP in this medical center. Observations revealed increasing prevalence of CRKP over the 14-year period, mirroring a national trend. Resistance toward most of the tested, clinically relevant drugs was observed in these CRKP strains. Positivity for carbapenemases was observed in the majority of these CRKP strains, with the Klebsiella pneumoniae carbapenemase as the dominant type (207/210, 98.6%). In 2016, there was an increase in the carrier rates of virulence genes uge, entB, fimH, mrkD and ureA, while relatively constant trend was noted for the ybtA, iucA and irp2. From MLST data, the preponderant sequence type (ST) was ST11 (88.8%, 190/214), followed by ST15 (1.9%, 4/214) and ST656 (1.4%, 3/214). Findings here indicate a relatively low prevalence of hypervirulent CRKP (such as ST15) as of 2016. They recommend performing continuous monitoring to keep track of CRKP and emphasize including the prospect of newly emerging strains with less common STs and the prospect of detecting carbapenem-resistant, carbapenemase-negative Klebsiella pneumoniae.