Characterization of carbapenem‐resistant Klebsiella pneumoniae in a tertiary hospital in Fuzhou, China

Abstract

Aims: The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) strains has led to increased mortality and morbidity rates. Tigecycline, a new class of broad-spectrum glycyl-tetracycline antibiotics, has been used to target multi-and pan-drug-resistant bacterial infections. This study aimed to assess the molecular characteristics of CRKP in a tertiary hospital, and its susceptibility to tigecycline, to create a reference for hospital infection control and clinical drug use. Methods and Results: We retrieved patient clinical information and CRKP characterization from medical records and detected the MIC of tigecycline using the micro-broth dilution method. Multi-locus sequence typing was performed, and antibiotic resistance genes associated with CRKP were detected by qPCR. A total of 166 CRKP strains were detected in the sputum, urine and blood among intensive care unit patients (average age, 69Á6 years). The most infrequently observed resistance genes were amikacin resistance genes, followed by tobramycin resistance genes. KPC-2, CTX-M9 and CTX-M1 were the most frequently detected resistance genes. Conclusions: No strain was resistant to tigecycline (MIC ≥ 8 µg ml À1). Twenty-four sequence types were identified, with ST11 being the most common type. Significance and Impact of the Study: Clinicians and infection control experts should be aware of CRKP prevalence to facilitate clinical treatment and improve nosocomial infection control.

ST11 Carbapenem-Resistant Klebsiella pneumoniae Clone Harboring blaNDM Replaced a blaKPC Clone in a Tertiary Hospital in China

“…Respiratory tract infections were the most common source of isolation, which agrees with the results reported by Chen et al in China [ 27 ]. In this study, CRE strains were mainly isolated in the neurosurgery (25%), intensive care unit (ICU; 16.8%), neurology (10%), and respiratory (6.9%) wards.…”

Antimicrobial Resistance Patterns, Sequence Types, Virulence and Carbapenemase Genes of Carbapenem-Resistant Klebsiella pneumoniae Clinical Isolates from a Tertiary Care Teaching Hospital in Zunyi, China

“…In China, it has been reported that the presence of KPC is responsible for carbapenem resistance in adult and pediatric isolates. 25 , 42 The present work demonstrated that the NDM and KPC genes detected in CRKP were mainly isolated in children and adults, respectively. Although OXA-48 is a prevalent carbapenemase type associated with Kp in some European countries, such as France and Turkey, 43 , 44 it is seldom detected in Kp isolates in China, 45 , 46 and the present study further support the observation that OXA-48 is not currently the primary carbapenemase types associated with Kp in China.…”

Analysis of Carbapenemase-Resistant Genotypes of Highly Virulent Klebsiella pneumoniae and Clinical Infection Characteristics of Different MLST Types

“…In the past, many common antibiotics can be selected for the treatment of Klebsiella pneumoniae pneumonia, such as ciprofloxacin, tobramycin, and cephalosporin, which have satisfactory bactericidal effects and can achieve significant clinical effects [15][16][17]. With the advent of broad-spectrum and high-efficiency antibiotics and excessive use, bacterial resistance has become stronger and more pan-resistant strains, especially the large-scale use of third and fourthgeneration cephalosporins and carbapenem antibiotics.…”