Carbapenemase Production and Epidemiological Characteristics of Carbapenem-Resistant Klebsiella pneumoniae in Western Chongqing, China

Abstract

BackgroundThis study aimed to determine the molecular characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates in a hospital in western Chongqing, southwestern China.MethodsA total of 127 unique CRKP isolates were collected from the Yongchuan Hospital of Chongqing Medical University, identified using a VITEK-2 compact system, and subjected to microbroth dilution to determine the minimal inhibitory concentration. Enterobacteriaceae intergenic repeat consensus polymerase chain reaction and multilocus sequence typing were used to analyze the homology among the isolates. Genetic information, including resistance and virulence genes, was assessed using polymerase chain reaction. The genomic features of the CRKP carrying gene blaKPC-2 were detected using whole-genome sequencing.ResultsST11 was the dominant sequence type in the homology comparison. The resistance rate to ceftazidime-avibactam in children was much higher than that in adults as was the detection rate of the resistance gene blaNDM (p < 0.0001). Virulence genes such as mrkD (97.6%), uge (96.9%), kpn (96.9%), and fim-H (84.3%) had high detection rates. IncF (57.5%) was the major replicon plasmid detected, and sequencing showed that the CRKP063 genome contained two plasmids. The plasmid carrying blaKPC-2, which mediates carbapenem resistance, was located on the 359,625 base pair plasmid IncFII, together with virulence factors, plasmid replication protein (rep B), stabilizing protein (par A), and type IV secretion system (T4SS) proteins that mediate plasmid conjugation transfer.ConclusionOur study aids in understanding the prevalence of CRKP in this hospital and the significant differences between children and adults, thus providing new ideas for clinical empirical use of antibiotics.

Risk factors and molecular epidemiology of fecal carriage of carbapenem resistant Enterobacteriaceae in patients with liver disease

“…The carrying rates of bla KPC-2 and bla NDM were 83.33% and 33.33%, respectively. It was noteworthy that multiple carbapenemase genes were detected in 25.58% (11/43) strains, which was also reported in previous studies [ 10 , 40 , 42 – 44 ]. bla IMP-4 and bla OXA-48 were also detected in some CRE isolates as one of multiple carbapenemase genes.…”

Clinical and resistance characterization of carbapenem-resistant Klebsiella pneumoniae isolated from intensive care units in China

“…Moreover, resistance rates basically showed a slight increase from previous local reports ( 27 , 28 ). It is worth noting that the resistance rate of CRKP to aminoglycosides was comparatively lower, consistent with the current status of drug resistance ( 29 ). The low resistance rate of aminoglycosides may be due to their adverse reactions and thus lower use in clinical practice, suggesting that scheduled shifting or switching of empirical medication might alleviate antibiotic resistance ( 30 ).…”

Molecular Characterization of Antibiotic Resistance Determinants in Klebsiella pneumoniae Isolates Recovered from Hospital Effluents in the Eastern Cape Province, South Africa

“…This study's low resistance to aminoglycosides could be due to its reduced usage. Similar to this study, a resistance rate of 38.6% against amikacin was reported among carbapenem-resistant Klebsiella pneumoniae isolates in China [31].…”