Emergence and establishment of KPC-2-producing ST11 Klebsiella pneumoniae in a general hospital in Shanghai, China

Liu, Jingxian; Yu, Jingjing; Chen, Feng; Yu, Jiajia; Simner, Patricia J.; Liu, Ying; Shen, Lisong

doi:10.1007/s10096-017-3131-4

Cited by 43 publications

(42 citation statements)

References 22 publications

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“…While that case is relatively specific since the patient might be affected during the visit and hospitalization in India, which would add more complex environmental factors to confound the results. CRKP of ST11 associated with bla KPC-2 is disseminated widely across China 18,29 , which is concordant with the results of our study. These findings all suggest that the CRKP-mediated infections in our hospital result from ST11 with KPC-2-positive K. pneumoniae isolates.…”

Section: Discussionsupporting

confidence: 92%

Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates with focus on antimicrobial resistance

Zhang

Zhao

et al. 2019

Preprint

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19The enhancing incidence of carbapenem-resistant Klebsiella pneumoniae (CRKP)-mediated 20 infections in Mengchao Hepatobiliary Hospital of Fujian Medical University in 2017 is the 21 motivation behind this investigation to study gene phenotypes and resistance-associated genes of 22 emergence regarding the CRKP strains. In current study, seven inpatients are enrolled in the 23 hospital with complete treatments. The carbapenem-resistant K. pneumoniae whole genome is 24 sequenced using MiSeq short-read and Oxford Nanopore long-read sequencing technology. 25Prophages are identified to assess genetic diversity within CRKP genomes. The investigation 26 encompassed eight CRKP strains that collected from the patients enrolled as well as the 27 environment, which illustrate that blaKPC-2 is responsible for phenotypic resistance in six CRKP 28 strains that K. pneumoniae sequence type (ST11) is informed. The plasmid with IncR, ColRNAI 29 and pMLST type with IncF[F33:A-:B-] co-exist in all ST11 with KPC-2-producing CRKP 30 strains. Along with carbapenemases, all K. pneumoniae strains harbor two or three extended 31 spectrum β-lactamase (ESBL)-producing genes. fosA gene is detected amongst all the CRKP 32 strains. The single nucleotide polymorphisms (SNP) markers are indicated and validated among 33 all CRKP strains, providing valuable clues for distinguishing carbapenem-resistant strains from 34 conventional K. pneumoniae. In conclusion, ST11 is the main CRKP type, and blaKPC-2 is the 35 dominant carbapenemase gene harbored by clinical CRKP isolates from current investigations. 36

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Section: Discussionsupporting

confidence: 92%

Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates with focus on antimicrobial resistance

Zhang

Zhao

et al. 2019

Preprint

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“…KPC‐2 was commonly associated with multiple STs, but ST258 was the most prevalent in the United States. The IncF groups dominate in the spread of KPC‐2 and KPC‐3 in the United States and other countries, including Australia, Canada, China, Italy, Romania, and Spain Only one study has reported on IncF groups in KPC‐3 in Portugal and Romania . Few occurrences were also reported in other countries, including the United States, Mexico, and Spain.…”

Section: Plasmid Biology and Incompatibility Groupsmentioning

confidence: 99%

Plasmid evolution in carbapenemase‐producing Enterobacteriaceae: a review

Kopotsa

Sekyere

Mbelle

2019

Annals of the New York Academy of Sciences

179

178

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Carbapenem‐resistant Enterobacteriaceae (CRE) have been listed by the WHO as high‐priority pathogens owing to their high association with mortalities and morbidities. Resistance to multiple β‐lactams complicates effective clinical management of CRE infections. Using plasmid typing methods, a wide distribution of plasmid replicon groups has been reported in CREs around the world, including IncF, N, X, A/C, L/M, R, P, H, I, and W. We performed a literature search for English research papers, published between 2013 and 2018, reporting on plasmid‐mediated carbapenem resistance. A rise in both carbapenemase types and associated plasmid replicon groups was seen, with China, Canada, and the United States recording a higher increase than other countries. blaKPC was the most prevalent, except in Angola and the Czech Republic, where OXA‐181 (n = 50, 88%) and OXA‐48–like (n = 24, 44%) carbapenemases were most prevalent, respectively; blaKPC‐2/3 accounted for 70% (n = 956) of all reported carbapenemases. IncF plasmids were found to be responsible for disseminating different antibiotic resistance genes worldwide, accounting for almost 40% (n = 254) of plasmid‐borne carbapenemases. blaCTX‐M, blaTEM, blaSHV, blaOXA‐1/9, qnr, and aac‐(6′)‐lb were mostly detected concurrently with carbapenemases. Most reported plasmids were conjugative but not present in multiple countries or species, suggesting limited interspecies and interboundary transmission of a common plasmid. A major limitation to effective characterization of plasmid evolution was the use of PCR‐based instead of whole‐plasmid sequencing–based plasmid typing.

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“…The molecular epidemiological methods had been used for tracking and characterization of CRKP isolates by PFGE and MLST which were accepted to differentiate the species-both of which indicated that CRKP ST11 was identi ed as the predominant sequence type strain in our study. The epidemiology of CRKP is continually evolving, and now the advantage strains of bla KPC -producing K. pneumoniae ST11 have been reported, which is the most frequently detected KPC-producing K. pneumoniae clone in China [14][15][16]. Interestingly, ST11 also occupied predominant isolates according to the prepotent PFGE pattern.…”

Section: Discussionmentioning

confidence: 99%

Molecular Epidemiology, Risk Factors and Outcomes of Carbapenem-Resistant Klebsiella Pneumoniae Infection in Eastern China: for A Retrospective Study Over 4 Years

Zhao¹,

Li²,

Yue³

et al. 2020

Preprint

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Objectives: Carbapenem-resistant Klebsiella pneumoniae (CRKP) have undergone extensive dissemination in worldwide resulting in increased mortality. We performed a retrospective analysis of epidemiology and risk factors for CRKP infection in a general teaching hospital in China.Methods: A molecular and clinical study were conducted for 98 CRKP in a tertiary hospital from January 2013 to December 2016. Carbapenemase gene detection, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were performed. Logistic regression was also used to identify the risk factors associating with the 30-day mortality.Results: The producition of KPC cabapenemase was the main resistant mechanism and increased annually with a significant difference. However, the molecular outcome revealed the dominance and diversity in CRKP with 24 sequence types (STs) and 59 PFGE types (PTs ). The ST11 CRKP were documented as the predominant strains in our study, which showed a significant increasing trend year by year. Additionally, the predominant ST11 CRKP corresponding to PT10 and PT15 remained a typical fashion. Of note, the new advantage PT09 or PT16 were just discovered in 2016 which also corresponding to ST11. Meanwhile, the factors on 30-day mortality and ST11 proportionality with CRKP infection were assessed, which showed that ST11, appropriate empirical treatment, and hospital stays were independently associated with 30-day mortality. Conclusions: ST11 CRKP payed a dominant role in the process, but the homology of these strains was polymorphic and the advantage clusters would be changed by evolution. Additionally, besides appropriate empirical treatment and hospital stays, ST11 CRKP was independently associated with the 30-day mortality, first reported as we know.

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Emergence and establishment of KPC-2-producing ST11 Klebsiella pneumoniae in a general hospital in Shanghai, China

Cited by 43 publications

References 22 publications

Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates with focus on antimicrobial resistance

Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates with focus on antimicrobial resistance

Plasmid evolution in carbapenemase‐producing Enterobacteriaceae: a review

Molecular Epidemiology, Risk Factors and Outcomes of Carbapenem-Resistant Klebsiella Pneumoniae Infection in Eastern China: for A Retrospective Study Over 4 Years

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