Drug Susceptibility and Molecular Epidemiology of Klebsiella pneumoniae Bloodstream Infection in ICU Patients in Shanghai, China

Abstract

Background: Bloodstream infections (BSIs) are recognized as important nosocomial infections. Klebsiella pneumoniae is one of the major causes of bacteremia. This retrospective study focused on drug susceptibility and molecular epidemiology of K. pneumoniae isolated from intensive care unit (ICU) patients with BSI in Shanghai, China.Methods: Consecutive K. pneumoniae isolates were collected from ICU patients. Antibiotic susceptibility testing was conducted by the broth microdilution method. PCR was performed to detect antimicrobial resistance genes. We also completed multilocus sequence typing (MLST) and GoeBURST was used to analyze the result of MLST.Results: A total of 78 K. pneumoniae isolates were enrolled. K. pneumoniae from ICU-BSIs were highly resistant to almost all common antibiotics. The most frequent resistance determinants responsible for extended-spectrum β-lactamase (ESBL) producers were blaCTX−M−14, blaCTX−M−15, and blaCTX−M−55. KPC was the only enzyme, which was detected by the carbapenemase producers. The most principal sequence types (STs) were ST11, ST15, and ST23.Conclusion: This study presents for the first time the antibiotic resistance phenotype and molecular epidemiology of K. pneumoniae isolated from ICU patients with BSIs in Shanghai. ICU-BSI K. pneumoniae is characteristic of a high resistance rate. The occurrence of the KPC-2 enzyme may result from nosocomial clonal dissemination of ST11 K. pneumoniae.

A 24-year longitudinal study of Klebsiella pneumoniae isolated from patients with bacteraemia and urinary tract infections reveals the association between capsular serotypes, antibiotic resistance, and virulence gene distribution

“…There was a high prevalence of MDR and XDR K. pneumoniae in our blood and urine isolates, which was consistent with previous studies [ 24 , 25 ]. Furthermore, rates of ampicillin resistance throughout the study period were largely stable, whereas resistance to other antibiotics fluctuated over time, as recently recorded by Lin et al [ 26 ].…”

Epidemiology of carbapenem-resistant Klebsiella pneumoniae ST15 of producing KPC-2, SHV-106 and CTX-M-15 in Anhui, China

“…In terms of antibiotic resistance, all ST15 CRKP have extremely high rates of resistance to common antibiotics, including amoxicillin/clavulanic acid, ceftriaxone, ceftazidime, cefoperazone/sulbactam, cefuroxime axetil, cefuroxime sodium, cefepime cefoxitin, ertapenem, imipenem, levofloxacin, and piperacillin/tazobactam, This is the same result found in a previous study of ST11 K. pneumoniae . Still, it is noteworthy that all ST15 in this study belonged to MDR, which is significantly higher than ST11 [ 26 ]. Meanwhile, according to antibiotic resistance results, we should use antibiotic treatment rationally.…”

Prevalence and Antimicrobial Resistance of Bloodstream Infections Caused by ESKAPEEc Pathogens: A Five-Year Analysis

“…The decreased ratio during the COVID-19 pandemic could be attributed to the increase in compliance with infection control measures, especially hand hygiene, as stated in Gaspari's study (12). In K. pneumoniae, identified as the most common cause of BSIs in 2016 -2020, third-generation cephalosporins, aminoglycoside, ciprofloxacin, and piperacillin-tazobactam resistance rates were found to be higher (80 -90%) from the findings of previous studies (13). In addition, tigecycline resistance was significantly increasing over the years, suggesting that tigecycline may not be a treatment option in the very near future.…”