High prevalence of metallo-β-lactamase among carbapenem-resistant <i>Klebsiella pneumoniae</i> in a teaching hospital in China

Li, Bin; Xu, Xiaohong; Zhao, Zhichang; Wang, Meihua; Cao, Yong

doi:10.1139/cjm-2014-0291

Cited by 19 publications

(16 citation statements)

References 25 publications

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“…1). Similar results have also been reported in other studies from China [9, 13, 14, 16, 20]. These studies showed that the effects of IMP hydrolase on different carbapenems may be diverse, and therefore, the carbapenem-sensitive phenotype does not mean negative for carbapenemase.…”

Section: Discussionsupporting

confidence: 89%

Molecular characterization of clinical IMP-producing Klebsiella pneumoniae isolates from a Chinese Tertiary Hospital

Lai

Guo

et al. 2017

Ann Clin Microbiol Antimicrob

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BackgroundIMP-producing Klebsiella pneumoniae (IMPKpn) exhibits sporadic prevalence in China. The mechanisms related to the spread of IMPKpn remain unclear.MethodsCarbapenem non-susceptible K. pneumoniae isolates were collected from our hospital. The genetic relatedness, antimicrobial susceptibility, as well as sequence types (ST) were analyzed by pulsed-field gel electrophoresis (PFGE), VITEK 2 AST test Kit, and multilocus sequence typing (MLST), respectively. S1-PFGE, Southern blot analysis and multiple PCR amplification were used for plasmid profiling.ResultsBetween October 2009 and June 2016, 25 non-repetitive IMPKpn isolates were identified. PFGE results showed that these isolates belonged to 20 genetically unrelated IMPKpn strains. Diverse STs were identified by MLST. Most strains carried bla IMP-4, followed by bla IMP-1. Four incompatibility types of bla IMP-carrying plasmids were identified, which included A/C (n = 2), B/O (n = 2), L/M (n = 1) and N (n = 14), while type of other one plasmid failed to be determined.ConclusionsThe IMPKpn isolates exhibited sporadic prevalence in our hospital. IncN types of plasmids with various sizes have emerged as the main platform mediating the spread of the bla IMP genes in our hospital.

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Section: Discussionsupporting

confidence: 89%

Molecular characterization of clinical IMP-producing Klebsiella pneumoniae isolates from a Chinese Tertiary Hospital

Lai

Guo

et al. 2017

Ann Clin Microbiol Antimicrob

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“…IMP-4 was found among four K. pneumoniae clinical isolates from neonates and three K. pneumonia e isolates from the environment of neonate ICU ( Yu et al, 2012 ). A high prevalence rate (55.0%, 22/40) of MBLs including IMP-4, IMP-8, and NDM-1 was found among CRKP isolates at a tertiary teaching hospital in southeastern China ( Li et al, 2014 ). Co-production of different carbapenamases was also found among clinically important organisms which poses a challenge for infection control ( Karthikeyan et al, 2010 ; Wei et al, 2011 ; Dortet et al, 2012 ; Kumarasamy and Kalyanasundaram, 2012 ; Rimrang et al, 2012 ).…”

Section: Resultsmentioning

confidence: 99%

Outbreak by Ventilator-Associated ST11 K. pneumoniae with Co-production of CTX-M-24 and KPC-2 in a SICU of a Tertiary Teaching Hospital in Central China

Liu

Deng

et al. 2016

Front. Microbiol.

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The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) often responsible for numerous hospital-associated outbreaks has become an important public health problem. From January 2013 to February 2014, a total of 41 non-duplicate K. pneumoniae isolates with carbapenem resistance, were collected at a tertiary teaching hospital in Nanchang, central China. Among 41 K. pneumoniae isolates, 28 were isolated from hospitalized patients including 19 from the patients in surgery intensive care unit (SICU) and 13 were isolated from ventilators. Twenty-four of 28 patients infected by CRKP have been submitted to mechanical ventilation using ventilator. More than 95% of the CRKP isolates were resistant to 13 antimicrobials tested. All CRKP isolates were confirmed as carbapenemase producer and were positive for blaKPC-2, with one positive for both blaKPC-2 and blaNDM-1. All carbapenemase-producing isolates harbored at least one of extended spectrum β-lactamase genes tested, among which 95.1% (39/41) of the tested isolates were found to harbor both blaCTX-M-24 and blaKPC-2, Of note, one isolate harbored simultaneously two carbapenemase genes (blaKPC-2 and blaNDM-1) and two ESBL genes (blaCTX-M-3 and blaTEM-104). To the best of our knowledge, coexistence of blaKPC-2 and blaCTX-M-24 in one isolate is first reported. MLST results showed that 41 CRKP isolates belonged to four sequence types (STs) including ST11, novel ST1854, novel ST1855, and ST1224. PFGE results displayed three PFGE clusters. Thirty-eight ST11 CRKP isolates (92.7%, 38/41) including all 13 isolates from ventilators and 25 isolates from patients from seven wards (18 from SICU) belonged to same PFGE cluster, indicating these isolates were clonally related. Fifteen isolates have an identical undistinguished pattern (100% similarity) forming a single clonal population. Moreover, this clone was exclusively linked to the cases attended in SICU and linked to the Ventilators. Additionally, the other SICU cases were linked to closely related clones (similarity greater than 95%). These data indicated that the occurrence of a clonal outbreak associated with ventilators has been found. In conclusion, outbreak by ventilator-associated ST11 K. pneumoniae with co-production of CTX-M-24 and KPC-2 is found in a SICU of a tertiary teaching hospital in central China.

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“…The major drug resistance gene in China and the United States is KPC, found in >90% of strains, with KPC-2 being the most common. The NDM-1 carrier rate is <10% in China and <5% in America (Deleo et al 2014;Li et al 2014). We suggest that screening be performed to detect other drug resistance genes to better understand the epidemiological trends of drug-resistant strains and provide a theoretical basis for infection control and clinical treatment.…”

Section: Discussionmentioning

confidence: 99%

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

Chen

Zhao

et al. 2020

J. Appl. Microbiol.

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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.

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High prevalence of metallo-β-lactamase among carbapenem-resistant Klebsiella pneumoniae in a teaching hospital in China

Cited by 19 publications

References 25 publications

Molecular characterization of clinical IMP-producing Klebsiella pneumoniae isolates from a Chinese Tertiary Hospital

Molecular characterization of clinical IMP-producing Klebsiella pneumoniae isolates from a Chinese Tertiary Hospital

Outbreak by Ventilator-Associated ST11 K. pneumoniae with Co-production of CTX-M-24 and KPC-2 in a SICU of a Tertiary Teaching Hospital in Central China

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

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