Tags

Type your tag names separated by a space and hit enter

Clonal replacement of epidemic KPC-producing Klebsiella pneumoniae in a hospital in China.
BMC Infect Dis. 2017 05 23; 17(1):363.BI

Abstract

BACKGROUND

Klebsiella pneumoniae is a frequent nosocomial pathogen causing difficult-to-treat infections worldwide. The prevalence of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (KPC-KP) is increasing in China. The aim of this study was to investigate the molecular epidemiology of KPC-KP in a nosocomial outbreak.

METHODS

Fifty-four KPC-KP isolates were consecutively collected between November 2013 and August 2014 during a KPC-KP outbreak in a tertiary care hospital in Beijing, China. Antimicrobial susceptibility was determined by agar dilution. Carbapenemase, extended-spectrum β-lactamase, 16S rRNA methylase, AmpC β-lactamase, and plasmid-mediated quinolone resistance determinants were detected by PCR amplification. The genetic relatedness of isolates was analyzed by pulsed-field gel electrophoresis and multi-locus sequence typing.

RESULTS

All isolates belonged to ST11 except one isolate which was identified as a new sequence type (ST2040). PFGE profile of genomic DNA revealed seven clusters, of which cluster A and C dominated the KPC-KP outbreak and cluster A was replaced by cluster C during the outbreak. PFGE of genomic DNA, S1-PFGE of plasmids, replicon typing, and drug resistant characteristics showed that clonal spread occurred during the outbreak. When compared with isolates within cluster A, all isolates in cluster C harbored rmtB and showed higher level of resistance to cefepime, amikacin, tobramycin, and tigecycline.

CONCLUSION

We reported a nosocomial outbreak of KPC-KP with clonal replacement and a new sequence type (ST2040) of KP. High degree of awareness and surveillance of KPC-KP should be given to avoid potential outbreaks, especially in ICU wards.

Authors+Show Affiliations

Department of Laboratory Medicine, Affiliated hospital of Academy of Military Medical Sciences, Beijing, People's Republic of China.Department of Laboratory Medicine, Affiliated hospital of Academy of Military Medical Sciences, Beijing, People's Republic of China.Department of Laboratory Medicine, Affiliated hospital of Academy of Military Medical Sciences, Beijing, People's Republic of China.Department of Laboratory Medicine, Affiliated hospital of Academy of Military Medical Sciences, Beijing, People's Republic of China. shpchen@hotmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28535790

Citation

Liang, Yuying, et al. "Clonal Replacement of Epidemic KPC-producing Klebsiella Pneumoniae in a Hospital in China." BMC Infectious Diseases, vol. 17, no. 1, 2017, p. 363.
Liang Y, Yin X, Zeng L, et al. Clonal replacement of epidemic KPC-producing Klebsiella pneumoniae in a hospital in China. BMC Infect Dis. 2017;17(1):363.
Liang, Y., Yin, X., Zeng, L., & Chen, S. (2017). Clonal replacement of epidemic KPC-producing Klebsiella pneumoniae in a hospital in China. BMC Infectious Diseases, 17(1), 363. https://doi.org/10.1186/s12879-017-2467-9
Liang Y, et al. Clonal Replacement of Epidemic KPC-producing Klebsiella Pneumoniae in a Hospital in China. BMC Infect Dis. 2017 05 23;17(1):363. PubMed PMID: 28535790.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clonal replacement of epidemic KPC-producing Klebsiella pneumoniae in a hospital in China. AU - Liang,Yuying, AU - Yin,Xiuyun, AU - Zeng,Lijun, AU - Chen,Shuiping, Y1 - 2017/05/23/ PY - 2016/10/19/received PY - 2017/05/16/accepted PY - 2017/5/25/entrez PY - 2017/5/26/pubmed PY - 2017/9/12/medline KW - Antimicrobial resistance KW - Carbapenemase KW - Clonal replacement KW - Epidemiology KW - Klebsiella pneumoniae SP - 363 EP - 363 JF - BMC infectious diseases JO - BMC Infect. Dis. VL - 17 IS - 1 N2 - BACKGROUND: Klebsiella pneumoniae is a frequent nosocomial pathogen causing difficult-to-treat infections worldwide. The prevalence of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (KPC-KP) is increasing in China. The aim of this study was to investigate the molecular epidemiology of KPC-KP in a nosocomial outbreak. METHODS: Fifty-four KPC-KP isolates were consecutively collected between November 2013 and August 2014 during a KPC-KP outbreak in a tertiary care hospital in Beijing, China. Antimicrobial susceptibility was determined by agar dilution. Carbapenemase, extended-spectrum β-lactamase, 16S rRNA methylase, AmpC β-lactamase, and plasmid-mediated quinolone resistance determinants were detected by PCR amplification. The genetic relatedness of isolates was analyzed by pulsed-field gel electrophoresis and multi-locus sequence typing. RESULTS: All isolates belonged to ST11 except one isolate which was identified as a new sequence type (ST2040). PFGE profile of genomic DNA revealed seven clusters, of which cluster A and C dominated the KPC-KP outbreak and cluster A was replaced by cluster C during the outbreak. PFGE of genomic DNA, S1-PFGE of plasmids, replicon typing, and drug resistant characteristics showed that clonal spread occurred during the outbreak. When compared with isolates within cluster A, all isolates in cluster C harbored rmtB and showed higher level of resistance to cefepime, amikacin, tobramycin, and tigecycline. CONCLUSION: We reported a nosocomial outbreak of KPC-KP with clonal replacement and a new sequence type (ST2040) of KP. High degree of awareness and surveillance of KPC-KP should be given to avoid potential outbreaks, especially in ICU wards. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/28535790/Clonal_replacement_of_epidemic_KPC_producing_Klebsiella_pneumoniae_in_a_hospital_in_China_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-017-2467-9 DB - PRIME DP - Unbound Medicine ER -