Epidemiological and Molecular Characteristics of blaNDM-1 and blaKPC-2 Co-Occurrence Carbapenem-Resistant Klebsiella pneumoniae

Abstract

Carbapenem-resistant Klebsiella pneumoniae (CRKP) has emerged and spread worldwide. It can usually cause a serious threat complicating treatment options in clinical settings. However, treatment options are limited. The present study investigates the prevalence and genetic characteristics of bla NDM-1 and bla KPC-2 co-harboring clinical isolates of Klebsiella pneumoniae. Methods: In this study, Multiplex polymerase chain reaction (PCR) was performed to detect the carbapenem-resistant genes, and the broth microdilution method was used to determine the minimum inhibitory concentrations (MICs) of antibacterial drugs. The transferability of carbapenem-resistant phenotypes was examined using filter mating assays. Overall, we used Illumina sequencing to evaluate the epidemiological and molecular characteristics of bla NDM-1 and bla KPC-2 (genes encoding carbapenemase) co-occurrence in CRKP strains. Results: All strains exhibited resistance to carbapenems and other antibiotics. However, they were still susceptible to polymyxin E. Among them, 18 isolates were positive for bla KPC-2 , bla NDM-1 , and multiple virulence determinants, such as genes encoding the virulence factor aerobactin, yersiniabactin, and the regulator of the mucoid phenotype (rmpA and rmpA2). Whole genome sequencing revealed that the 18 CRKP strains belonged to ST11 and capsular serotype KL64, and could be grouped into two evolutionary branches. Furthermore, these strains displayed hypervirulence potential since all of them carried pLVPK-like plasmid. Conclusion: These findings suggested that ST11-KL64 CRKP strains are major threats in terms of nosocomial infections in this hospital. Hence, new strategies should be urgently developed to monitor, diagnose, and treat this high-risk CRKP clone.

Molecular characteristics of carbapenem-resistant Enterobacteriaceae isolated from two tertiary hospitals in the Philippines

“…Studies attribute this co-existence to clonal gene transmission resulting in a stable clone that has the potential to spread among patients (Gao et al 2020;Zhang et al 2020). Harboring different carbapenemase classes such as KPC-2 and NDM-1 may confer even higher resistance to carbapenems as well as other antimicrobials (Gao et al 2020).…”

Clinical and Molecular Characteristics of Patients with Bloodstream Infections Caused by KPC and NDM Co-Producing Carbapenem-Resistant Klebsiella pneumoniae

“… 1 , 2 Recently, KPC and NDM co-producing K. pneumoniae (KPC-NDM-CRKP) isolates have been increasingly reported in China and many regions of the world. 3 , 4 …”

“…Keywords: KPC and NDM co-producing carbapenem-resistant Klebsiella pneumoniae, Bloodstream infections, risk factors, molecular characteristics, mortality Recently, KPC and NDM co-producing K. pneumoniae (KPC-NDM-CRKP) isolates have been increasingly reported in China and many regions of the world. 3,4…”