Molecular epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae among children in China

Jin, Zhengjiang; Wang, Zhenhui; Gong, Lin; Lu, Yi; Liu, Nian; Luo, Lan; Gong, Wenting

doi:10.1186/s13568-022-01437-3

Cited by 6 publications

(6 citation statements)

References 44 publications

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“…In China, it has been reported that the presence of KPC is responsible for carbapenem resistance in adult and pediatric isolates. 25 , 42 The present work demonstrated that the NDM and KPC genes detected in CRKP were mainly isolated in children and adults, respectively. Although OXA-48 is a prevalent carbapenemase type associated with Kp in some European countries, such as France and Turkey, 43 , 44 it is seldom detected in Kp isolates in China, 45 , 46 and the present study further support the observation that OXA-48 is not currently the primary carbapenemase types associated with Kp in China.…”

Section: Discussionsupporting

confidence: 55%

“… 51 In Jiangsu Province, and Wuhan, China, the main antimicrobial resistance gene in pediatric patients carried by CRKP was KPC2, and the prevalent strains were ST11 with high virulence and antimicrobial resistance. 6 , 25 Another work in Shenzhen demonstrated that ST307 was the most dominant genotype, and NDM represented the main resistance mechanism. 52 On the other hand, most of the isolates belonged to ST2407, which produces NDM enzymes, as revealed in this work.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have investigated the epidemiology and antimicrobial resistance patterns of CRKP isolates in some cities in China; 6 , 25 , 26 however, no detailed reports of antimicrobial resistance patterns and STs have been described in Zunyi, Guizhou Province, China. The present study aimed to investigate the antimicrobial resistance patterns, STs, and presence of virulence genes ( magA, rmpA, wabG, uge, fimH , and kfu ) and carbapenemase genes (KPC, NDM, OXA-48, IMP, and VIM) in CRKP isolates from patients at the First People’s Hospital of Zunyi (the Third Affiliated Hospital of Zunyi Medical University) in Zunyi, Guizhou Province, China, between January 2018 and December 2020.…”

Section: Introductionmentioning

confidence: 99%

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Antimicrobial Resistance Patterns, Sequence Types, Virulence and Carbapenemase Genes of Carbapenem-Resistant Klebsiella pneumoniae Clinical Isolates from a Tertiary Care Teaching Hospital in Zunyi, China

Shen¹,

Chen²,

He³

et al. 2023

IDR

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Purpose Carbapenem-resistant Klebsiella pneumoniae (CRKP) has seriously threatened public health worldwide. This study aimed to investigate the antimicrobial resistance patterns, sequence types (STs), virulence and carbapenemase genes of CRKP isolates from patients in Zunyi, China. Methods CRKP isolates were collected from the First People’s Hospital of Zunyi between January 2018 and December 2020. Antimicrobial susceptibility was determined using a VITEK ® 2 analyzer and confirmed using either the broth dilution method, Kirby–Bauer method, or E-test assays. Carbapenemase production was examined using a modified carbapenem inactivation method. STs of the studied isolates were determined by multilocus sequence typing, and the presence of carbapenemase and virulence genes was examined using polymerase chain reaction assays. Results In total, 94 CRKP isolates were collected. All studied isolates produced carbapenemase, and the most common carbapenemase gene was New Delhi metallo-β-lactamase (NDM; 72.3%), followed by Klebsiella pneumoniae carbapenemase (KPC; 24.5%), and Verona integron-encoded metallo-β-lactamase (VIM; 3.2%). Of the studied isolates, 74.3% exhibited multidrug-resistant (MDR) phenotype, and 25.7% were either pandrug-resistant (PDR) or extensively drug-resistant (XDR) phenotypes. The most prevalent sequence type was ST2407 (37.2%), followed by ST76 (21.3%) and ST11 (11.7%). The NDM gene was present in 97.1% of ST2407 isolates and 90.0% of ST76 isolates, whereas the KPC gene was present in 90.9% of ST11 isolates. The majority of the isolates carried wabG, uge , and fimH virulence genes, with prevalence rates of 94.7%, 92.6%, and 94.7%, respectively. Conclusion This study describes NDM-producing ST2407 and ST76, as well as KPC-producing ST11, as the major clonal types of CRKP isolates in Zunyi, China. All CRKP isolates were resistant to multiple types of antibiotics, and the majority of isolates carried carbapenemase and virulence genes. Clonal spread of NDM-producing CRKP ST2407 and ST76, and KPC-producing CRKP ST11 should be strictly monitored.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Antimicrobial Resistance Patterns, Sequence Types, Virulence and Carbapenemase Genes of Carbapenem-Resistant Klebsiella pneumoniae Clinical Isolates from a Tertiary Care Teaching Hospital in Zunyi, China

Shen¹,

Chen²,

He³

et al. 2023

IDR

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“… 6 The most common mechanism of carbapenem resistance in K. pneumoniae collected from children is KPC-2, but the prevalence of NDM, especially NDM-1, is higher than in adults in China. 10 , 11 The dominant clone of CRKP is ST11, which usually carries multiple resistance genes via plasmids and causes nosocomial infection outbreaks. 12 The spread of ST11 may have contributed to the increasing trend of multiple and even extensive drug resistance in K. pneumoniae since 2015.…”

Section: Amr Prevalence and Trends In Gram-negative Bacillimentioning

confidence: 99%

Antimicrobial resistance of clinical bacterial isolates in China: current status and trends

Qin,

Ding,

Hao

et al. 2024

JAC-Antimicrobial Resistance

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Antimicrobial resistance surveillance systems have been established in China. Two representative national surveillance networks are the China Antimicrobial Surveillance Network (CHINET) and China Antimicrobial Resistance Surveillance System (CARSS), both of which were established in 2005. For all clinical isolates collected in both of these surveillance networks, the ratio of Gram-negative bacilli to Gram-positive cocci was approximately 7:3 during the past 18 years. Generally, Gram-negative bacilli have a higher antimicrobial resistance profile in China. The prevalence of ESBLs in Escherichia coli is as high as approximately 50%. Acinetobacter baumannii-calcoaceticus complex (ABC) has a high antimicrobial resistance profile, with a carbapenem resistance rate of approximately 66%. However, the prevalence of carbapenem-resistant ABC has also shown a decreasing trend from 2018 to 2022. The prevalence of vancomycin-resistant Enterococcus was low, and the prevalence of MRSA and carbapenem-resistant Pseudomonas aeruginosa showed decreasing trends from 2005 to 2022. CHINET surveillance data demonstrated that the prevalence of carbapenem-resistant Klebsiella pneumoniae showed a remarkable increasing trend from 2.9% (imipenem resistance) in 2005 to 25.0% in 2018, and then slightly decreased to 22.6% in 2022. The decreasing trends may reflect the antimicrobial stewardship efforts in China: a professional consensus on the rational clinical use of carbapenems was issued by the National Health Commission of China and was well implemented nationally; after that, the clinical use of carbapenems decreased slightly in China.

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“…With the widespread use of carbapenem antibiotics, there have been an increasing number of corresponding carbapenem-resistant Enterobacterales (CRE). 1 The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) emphasize that CRE is an urgent threat to public health. 2 Klebsiella pneumoniae , one of the most significant species of Enterobacterales , is second only to Escherichia coli in the clinical isolation rate among gram-negative bacilli.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors and Molecular Mechanism of Polymyxin B Resistance in Carbapenem-Resistant Klebsiella pneumoniae Isolates from a Tertiary Hospital in Fujian, China

Xu¹,

Zhu²,

Lian³

et al. 2022

IDR

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Background The emergence of polymyxin B resistance among carbapenem-resistant Klebsiella pneumoniae (CRKP) causes clinical treatment to be more difficult. We aimed to investigate the risk factors and resistance mechanisms in the polymyxin resistant CRKP (PR-CRKP) strains. Methods From January 2021 to January 2022, 239 CRKP strains were selected, all of which were analyzed using antimicrobial susceptibility testing and clinical data. Polymerase chain reaction (PCR) was performed for the detection of resistance genes. RT-qPCR was used to quantify transcriptional levels of polymyxin resistance genes. Risk factors for polymyxin B resistant isolates were identified by logistic regression analysis. Results The resistance rate of polymyxin B was 5.02%. In all CRKP strains, 41.84% came from the ICU. The percentage of carbapenemase producing strains was 93.72%. The main carbapenem resistance gene was bla KPC (90.79%). In the 12 strains of PR-CRKP screened, pmrB and pmrK were overexpressed in all samples which were linked with polymyxin B resistance. Multivariate analysis showed that coronary heart disease may be an independent risk factor predisposing patients to polymyxin B resistance. Conclusion We determine the multifaceted mechanism and risk factors of polymyxin B resistance in CRKP. Polymyxin resistance is a complex and changing problem, and more research is required.

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Molecular epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae among children in China

Cited by 6 publications

References 44 publications

Antimicrobial Resistance Patterns, Sequence Types, Virulence and Carbapenemase Genes of Carbapenem-Resistant Klebsiella pneumoniae Clinical Isolates from a Tertiary Care Teaching Hospital in Zunyi, China

Antimicrobial Resistance Patterns, Sequence Types, Virulence and Carbapenemase Genes of Carbapenem-Resistant Klebsiella pneumoniae Clinical Isolates from a Tertiary Care Teaching Hospital in Zunyi, China

Antimicrobial resistance of clinical bacterial isolates in China: current status and trends

Risk Factors and Molecular Mechanism of Polymyxin B Resistance in Carbapenem-Resistant Klebsiella pneumoniae Isolates from a Tertiary Hospital in Fujian, China

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