The Characterization of OXA-232 Carbapenemase-Producing ST437 <i>Klebsiella pneumoniae</i> in China

Weng, Xing‐bei; Shi, Qiucheng; Wang, Sheng; Shi, Yubo; Sun, Dan; Yu, Yunsong

doi:10.1155/2020/5626503

Cited by 20 publications

(15 citation statements)

References 26 publications

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“… 4 The plasmid pOXA-232 was a non-conjugative plasmid because it could not be transferred through conjugation experiments. 4 , 9 , 28 The plasmid in our experimental strains was similar to plasmids in other studies. 4–7 , 9 , 28 , 29 The conjugation experiment failed to transfer this bla OXA-232 into E. coli , indicating that it was a non highly conjugative plasmid.…”

Section: Discussionsupporting

confidence: 84%

“… 4 , 9 , 28 The plasmid in our experimental strains was similar to plasmids in other studies. 4–7 , 9 , 28 , 29 The conjugation experiment failed to transfer this bla OXA-232 into E. coli , indicating that it was a non highly conjugative plasmid. However, we found OXA-232-producing E. coli during the outbreak.…”

Section: Discussionsupporting

confidence: 84%

“… 5 , 7 The main sequence type (ST) in the OXA-232-producing CRKP from China is ST15; but recent studies have reported that the OXA-232 is also present in ST437 K. pneumoniae clinical isolates, a newly discovered clone of high-risk multidrug-resistant (MDR) CC11. 5–7 , 9 Currently, a few studies have reported the virulence of OXA-232-producing CRKP. Although researchers from China have reported the OXA-232-producing CRKP with a plVPK-like virulent plasmid, its virulence level was not high.…”

Section: Introductionmentioning

confidence: 99%

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Outbreak of Multidrug-Resistant OXA-232-Producing ST15 Klebsiella pneumoniae in a Teaching Hospital in Wenzhou, China

Jia¹,

Zhang²,

Ye³

et al. 2021

IDR

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Background OXA-232-producing carbapenem-resistant Klebsiella pneumoniae (CRKP) has the potential to become the “third epidemic” of carbapenem-resistant Klebsiella strain after KPC-2 and NDM in China. We investigated the first outbreak of CRKP in the First Affiliated Hospital of Wenzhou Medical University. Methods We collected 610 clinical isolates of CRKP from the First Affiliated Hospital of Wenzhou Medical University between January 2019 and September 2020 and screened them by Polymerase Chain Reaction (PCR). The multilocus sequence typing and pulsed-field gel electrophoresis were used to determine the genetic relatedness of the strains. The antimicrobial susceptibility test was performed to determine the drug resistance of the clinical isolates. The molecular mechanism underlying carbapenem resistance was elucidated by performing PCR and conjugation experiments. The virulence potential of the strains was determined by the string test, detection of virulence-associated genes and capsular serotypes, and Galleria mellonella larval infection model. Results Between September 2019 and May 2020, 26 OXA-232-producing CRKP were obtained from 12 patients in our hospital. Ten patients were hospitalized in the intensive care units (ICU) and the overall mortality of the inpatients involved in the outbreak was 50% (6/12). Epidemiological investigations reported that all the OXA-232-producing CRKP strains belonged to the sequence type ST15 and can be clonally transmitted among the inpatients in the ICU. All the strains had low virulence and were resistant to commonly used clinical antibiotics except for ceftazidime/avibactam, colistin, and tigecycline. The OXA-232-producing CRKP was sensitive to triclosan and chlorhexidine, and its eradication from our hospital can be achieved by the use of disinfectants in the ICU. Conclusion In our study, OXA-232-producing CRKP isolates appeared to be clonally transmitted and the sequence type ST15 was responsible for the outbreak. Therefore, effective measurements for the infection control of CRKP are urgently needed to prevent its epidemic in the nearby region in the future.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

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Outbreak of Multidrug-Resistant OXA-232-Producing ST15 Klebsiella pneumoniae in a Teaching Hospital in Wenzhou, China

Jia¹,

Zhang²,

Ye³

et al. 2021

IDR

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“…The majority of these showed phenotypic resistance to both meropenem and imipenem (256/280, 91.4%, Figure 1A), explained by the presence of blaOXA-48-like genes, blaNDM genes, and a combination of ESBLs (blaCTX-M-15, blaCTX-M-71, blaSHV-12, blaSHV-13, blaSHV-27, blaSHV-31, blaSHV-41) and inactivation of porins Ompk35/36 [27]. Of the carbapenem-resistant isolates, 80.3% (225/280) carried blaOXA-48-like genes (blaOXA181 and blaOXA232), and 26.7% (75/280) carried blaNDM-1/5, which supports the reported changing trends in carbapenem resistance [25].…”

Section: Resistance Profile and Their Distributionmentioning

confidence: 99%

High-Resolution Genomic Profiling of Carbapenem-Resistant Klebsiella pneumoniae Isolates: A Multicentric Retrospective Indian Study

Nagaraj

Ravikumar

Govindan

et al. 2021

Preprint

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Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a threat to public health in India due to its high dissemination, mortality, and limited treatment options. Its genomic variability is reflected in the diversity of sequence types, virulence factors, and antimicrobial resistance (AMR) mechanisms. This study aims to characterize the clonal relationships and genetic mechanisms of resistance and virulence in CRKP isolates in India. Materials and Methods: We characterized 344 retrospective K. pneumoniae clinical isolates collected from 8 centers across India collected in 2013-2019. Susceptibility to antibiotics was tested with VITEK 2. Capsular types, MLST, virulence genes, AMR determinants, plasmid replicon types, and a single-nucleotide polymorphism (SNP) phylogeny were inferred from their whole genome sequences. Results: Phylogenetic analysis of the 325 Klebsiella isolates that passed QC revealed 3 groups: K. pneumoniae sensu stricto (n=307), K. quasipneumoniae (n=17), and K. varicolla (n=1). Sequencing and capsular diversity analysis of the 307 K. pneumoniae sensu stricto isolates revealed 28 sequence types, 26 K-locus types, and 11 O-locus types, with ST231, KL51, and O1V2 being predominant. blaOXA-48-like and blaNDM-1/5 were present in 73.2% and 24.4% of isolates respectively. The major plasmid replicon types associated with carbapenase genes were IncF (51.0%), and Col group (35.0%). Conclusion: Our study documents for the first time the genetic diversity of K- and O-antigens circulating in India. The results demonstrate the practical applicability of genomic surveillance and its utility in tracking the population dynamics of CRKP. It alerts us to the urgency for longitudinal surveillance of these virulent and transmissible lineages.

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“…The emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) has created an escalating global threat with the dissemination of carbapenemase genes. The most common carbapenemase genes include blaKPC, blaNDM, blaVIM, blaIMP, and blaOXA-48-like (1). A nationwide survey conducted in China showed that acquisition of two carbapenemase genes, blaKPC-2 and blaNDM, was responsible for phenotypic resistance in 90% of the CRE strains tested (58 and 32%, respectively) (2).…”

Section: Introductionmentioning

confidence: 99%

Clinical and Microbiological Characteristics of a Community-Acquired Carbapenem-Resistant Escherichia coli ST410 Isolate Harbouring blaNDM-5-Encoding IncX3-Type Plasmid From Blood

Chen

Weng

et al. 2021

Front. Med.

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Objectives: The aim of this research was to investigate the clinical and microbiological characteristics of a case of community-acquired carbapenem-resistant Escherichia coli isolated from a patient with a bloodstream infection in China.Methods:Escherichia coli Huamei202001 was recovered from the first blood culture from a patient hospitalised in China. An antimicrobial susceptibility test was performed, and the genome was sequenced on an Illumina HiSeq X 10 platform with a 150-bp paired-end approach. The generated sequence reads were assembled using Unicycler, and the whole genome sequence data were analysed using bioinformatics tools. Moreover, the patient and her main family members obtained a faecal sample screening test for CRE, the positive strain was further isolated and the identification and antimicrobial susceptibility testing was performed.Results:Escherichia coli Huamei202001 belonged to sequence type 410. In addition, a blaNDM-5-encoding IncX3-type plasmid was responsible for the spreading of carbapenem resistance. Only the patient was detected as having a positive faecal sample screening test for CRE. Strain Fec01 was identified as E. coli, and the antibiotic susceptibility profile was the same as that of E. coli Huamei202001.Conclusions:Escherichia coli Huamei202001 is defined as community-acquired carbapenem-resistant Enterobacteriaceae. The clone ST410 that harbours the blaNDM-5-encoding IncX3-type plasmid is causing new high-risk clones globally. Thus, infection control measures should be strengthened to curb the dissemination of IncX3.

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The Characterization of OXA-232 Carbapenemase-Producing ST437 Klebsiella pneumoniae in China

Cited by 20 publications

References 26 publications

Outbreak of Multidrug-Resistant OXA-232-Producing ST15 Klebsiella pneumoniae in a Teaching Hospital in Wenzhou, China

Outbreak of Multidrug-Resistant OXA-232-Producing ST15 Klebsiella pneumoniae in a Teaching Hospital in Wenzhou, China

High-Resolution Genomic Profiling of Carbapenem-Resistant Klebsiella pneumoniae Isolates: A Multicentric Retrospective Indian Study

Clinical and Microbiological Characteristics of a Community-Acquired Carbapenem-Resistant Escherichia coli ST410 Isolate Harbouring blaNDM-5-Encoding IncX3-Type Plasmid From Blood

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