<p>Epidemic Characteristics of Carbapenem-Resistant <em>Klebsiella pneumoniae</em> in the Pediatric Intensive Care Unit of Yanbian University Hospital, China</p>

Abstract

Introduction: Carbapenem-resistant Enterobacteriaceae (CRE) pose a serious threat to clinical patient management and public health, as they are generally resistant to most antibiotics and cause infections with high mortality rates. Klebsiella pneumoniae ranks second among Enterobacteriaceae species that cause nosocomial infections. In this study, we investigated the epidemic characteristics of carbapenem-resistant K. pneumoniae (CRKP) in the pediatric intensive care unit (PICU) of Yanbian University Hospital. Materials and Methods: A total of 14 non-duplicate CRKP strains, collected from March 2015 to November 2019, were subjected to automated microbial identification and antimicrobial susceptibility tests using the Phoenix-100 ID/AST system. The strains were also subjected to genotypic resistance testing, polymerase chain reaction assays to detect genes encoding carbapenemases and other β-lactamases, multi-locus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE)-based homology analysis. Results: Two carbapenemase genes, KPC-2 and NDM-1 (in eight and six strains, respectively), were detected. MLST enabled the division of the strains into two sequence types, ST11 and ST1224 (containing eight and six strains, respectively). PFGE results classified the 14 strains into clonotypes AD , of which clonotypes A and B belonged to ST11, while clonotypes C and D belonged to ST1224. Conclusion: Our study reveals that epidemics of the KPC-2-ST11 and NDM-1-ST1224 strains occurred in the PICU of Yanbian University Hospital. Surveillance and strict implementation of prevention and control measures are crucial to prevent the occurrence and rapid spread of nosocomial infections.

Characterization of Carbapenem-Resistant Klebsiella pneumoniae ST15 Clone Coproducing KPC-2, CTX-M-15 and SHV-28 Spread in an Intensive Care Unit of a Tertiary Hospital

“…19 The DNA of the strains was extracted by boiling method as PCR template. 20 Polymerase chain reaction (PCR) was used to detect carbapenem resistance genes (bla KPC , bla NDM , bla OXA-48 , bla VIM , bla IMP ), ESBL genes (bla CTX-M-1G , bla CTX-M-2G , bla CTX-M-8G , bla CTX-M-9G , bla SHV , bla TEM , bla OXA-1 ), plasmid-mediated quinolone resistance (PMQR) genes (qnrA, qnrB, qnrS, aac(6ʹ)-Ibcr), 16S rRNA methylase genes (armA, rmtB) and colistin resistance gene (mcr-1). [21][22][23][24][25] The positive amplified products were sequenced, and the sequences were compared with the database in the National Center for Biotechnology Information (NCBI) (https://www.ncbi.nlm.nih.gov/) by BLAST searches.…”

Three Novel Sequence Types Carbapenem-Resistant Klebsiella pneumoniae Strains ST5365, ST5587, ST5647 Isolated from Two Tertiary Teaching General Hospitals in Shanxi Province, in North China: Molecular Characteristics, Resistance and Virulence Factors

“…Recommended by the CLSI2020, in this study, phenotypic screening for preliminarily determining whether the strain produced metallo-carbapenemase was performed in accordance with the modified Carbapenem Inactivation Method (mCIM) and EDTA-Modified Carbapenem Inactivation Method (eCIM). 25 To be brief, a single colony of isolates was inoculated into a tube containing 2 mL trypticase soy broth (TSB) and a tube containing 2 mL TSB with 5mM EDTA, respectively, and then stir the colony immediately to dissolve enough to be invisible. A disk containing 10 μg meropenem was placed in each tube and incubated at 37°C for 4 h. After that, these disks were taken out and placed on MH agar plates that were inoculated with a lawn of the meropenem-susceptible Escherichia coli ATCC25922 (0.5 McFarland standard).…”

Microbial Air Quality in Healthcare Facilities

“…The most commonly contaminated samples were collected from humidifiers, refrigerators, incubators, medication trolleys, trays and boxes and intensive care equipment. In a pediatric ICU, endemic multidrug-resistant Klebsiella pneumoniae was frequently isolated [ 68 , 69 ].…”