Outbreak of NDM-1-producing Klebsiella pneumoniae ST76 and ST37 isolates in neonates

Abstract

The purpose of this study was to investigate the epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP) in Shanghai Children's Hospital in China. Twenty-two non-duplicate CRKP strains were collected from pediatric patients between March and June in 2014. Antimicrobial susceptibility testing was conducted by the agar dilution method. Beta-lactamases were characterized by polymerase chain reaction (PCR) and DNA sequencing. The transferability of bla NDM-1 was investigated by conjugation experiment. The plasmids bearing antibiotic resistance genes were characterized by S1 nuclease pulsed-field gel electrophoresis (S1-PFGE) and Southern hybridization. Clonal relatedness was evaluated by PFGE and multilocus sequence typing (MLST). The clinical data of patients were retrospectively reviewed. The 22 CRKP strains were resistant to most of the antimicrobial agents tested, except tigecycline and colistin. Overall, 59, 77, and 100 % of these strains were resistant to imipenem, meropenem, and ertapenem, respectively. The bla NDM-1 was positive in 77.3 % (17/22) of the CRKP strains, of which the 16 isolates from inpatients were designated as ST37 (n = 9) and ST76 (n =7) and one isolate from an outpatient belonged to ST846. The 17 bla NDM-1-positive isolates belonged to PFGE type A (n = 9), type C (n = 7), or type B (n = 1). The plasmids bearing bla NDM-1 could be transferred into recipient Escherichia coli J53 through conjugation in 88.2 % (15/17) of the strains. The hybridization results showed that the plasmids carrying the bla NDM-1 gene were approximately 50-240 kb in size. This is the first report of an outbreak caused by NDM-1-producing K. pneumoniae ST76 and ST37 among neonates.

An Uncommon ST1224 NDM-1-Producing <b><i>Klebsiella pneumoniae</i></b> Isolated from the Bloodstream of a Leukemia Patient in China

“…These results would suggest that the transfer of bla NDM-1 was mediated by plasmid, just as a previous report described [16]. In China, the most common K. pneumoniae strains were ST11 and ST14 [10,19]. NDM-1-producing K. pneumoniae ST17, ST20, and ST147 have been reported in Shandong and Shanxi provinces [1,20].…”

“…In China, NDM-1-producing K. pneumoniae has been reported in several regions [19]. It is the first NDM-1-positive K. pneumoniae strain isolated from our hospital, but the origin of this NDM-1-positive K. pneumoniae remains unclear.…”

Molecular and microbiological report of a hospital outbreak of NDM-1-carrying Enterobacteriaceae in Mexico

“…pneumoniae ST307, ST392, and ST846 which have been reported as harboring bla KPC, bla OXA-48 and bla NDM-1 genes [43–45]. In contrast, the K .…”

Defining and Evaluating a Core Genome Multilocus Sequence Typing Scheme for Whole-Genome Sequence-Based Typing of Klebsiella pneumoniae

“…Among these techniques, multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) are the two most frequently used methods to investigate outbreaks of K. pneumoniae infection (Jin et al, 2015; Mshana et al, 2015; Zhu et al, 2016). PFGE has the ability to definite and distinguish outbreak and non-outbreak isolates and PFGE data can be exchanged between the different labs (Swaminathan et al, 2001).…”