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Multidrug Resistance Mechanisms of Carbapenem Resistant Klebsiella pneumoniae Strains Isolated in Chongqing, China.
Ann Lab Med 2017; 37(5):398-407AL

Abstract

BACKGROUND

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is considered a serious global threat. However, little is known regarding the multidrug resistance (MDR) mechanisms of CRKP. This study investigated the phenotypes and MDR mechanisms of CRKP and identified their clonal characteristics.

METHODS

PCR and sequencing were utilized to identify antibiotic resistance determinants. Integron gene cassette arrays were determined by restriction fragment length polymorphism (RFLP) analysis. Multi-locus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) were used for epidemiological analysis. Plasmids were typed by using a PCR-based replicon typing and analyzed by conjugation and transformation assays.

RESULTS

Seventy-eight strains were identified as resistant to at least one carbapenem; these CRKP strains had a high prevalence rate (38.5%, 30/78) of carbapenemase producers. Additionally, most isolates harbored MDR genes, including Extended spectrum β-lactamases (ESBLs), AmpC, and quinolone and aminoglycoside resistance genes. Loss of porin genes was observed, and Class 1 integron was detected in 66.7% of the investigated isolates. PFGE and MLST results excluded the occurrence of clonal dissemination among these isolates.

CONCLUSIONS

A high prevalence of NDM-1 genes encoding carbapenem resistance determinants was demonstrated among the K. pneumoniae isolates. Importantly, this is the first report of bla(NDM-1) carriage in a K. pneumoniae ST1383 clone in China and of a MDR CRKP isolate co-harboring bla(NDM-1), bla(KPC-2), bla(CTX-M), bla(SHV), acc(6')-Ib, rmtB, qnrB, and acc(6')-Ib-cr.

Authors+Show Affiliations

Department of Clinical Laboratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.Department of Clinical Laboratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.Department of Clinical Laboratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.Department of Clinical Laboratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.Department of Clinical Laboratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.Department of Clinical Laboratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.Department of Clinical Laboratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.Department of Clinical Laboratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. 1309898173@qq.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28643488

Citation

Yan, Jinrong, et al. "Multidrug Resistance Mechanisms of Carbapenem Resistant Klebsiella Pneumoniae Strains Isolated in Chongqing, China." Annals of Laboratory Medicine, vol. 37, no. 5, 2017, pp. 398-407.
Yan J, Pu S, Jia X, et al. Multidrug Resistance Mechanisms of Carbapenem Resistant Klebsiella pneumoniae Strains Isolated in Chongqing, China. Ann Lab Med. 2017;37(5):398-407.
Yan, J., Pu, S., Jia, X., Xu, X., Yang, S., Shi, J., ... Zhang, L. (2017). Multidrug Resistance Mechanisms of Carbapenem Resistant Klebsiella pneumoniae Strains Isolated in Chongqing, China. Annals of Laboratory Medicine, 37(5), pp. 398-407. doi:10.3343/alm.2017.37.5.398.
Yan J, et al. Multidrug Resistance Mechanisms of Carbapenem Resistant Klebsiella Pneumoniae Strains Isolated in Chongqing, China. Ann Lab Med. 2017;37(5):398-407. PubMed PMID: 28643488.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multidrug Resistance Mechanisms of Carbapenem Resistant Klebsiella pneumoniae Strains Isolated in Chongqing, China. AU - Yan,Jinrong, AU - Pu,Shuli, AU - Jia,Xiaojiong, AU - Xu,Xiuyu, AU - Yang,Shuangshuang, AU - Shi,Jing, AU - Sun,Shan, AU - Zhang,Liping, PY - 2016/11/24/received PY - 2017/02/10/revised PY - 2017/05/22/accepted PY - 2017/6/24/entrez PY - 2017/6/24/pubmed PY - 2018/4/5/medline KW - Carbapenem-resistant KW - Carbapenemases KW - Extended spectrum β-lactamases KW - Klebsiella pneumoniae KW - Molecular epidemiology SP - 398 EP - 407 JF - Annals of laboratory medicine JO - Ann Lab Med VL - 37 IS - 5 N2 - BACKGROUND: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is considered a serious global threat. However, little is known regarding the multidrug resistance (MDR) mechanisms of CRKP. This study investigated the phenotypes and MDR mechanisms of CRKP and identified their clonal characteristics. METHODS: PCR and sequencing were utilized to identify antibiotic resistance determinants. Integron gene cassette arrays were determined by restriction fragment length polymorphism (RFLP) analysis. Multi-locus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) were used for epidemiological analysis. Plasmids were typed by using a PCR-based replicon typing and analyzed by conjugation and transformation assays. RESULTS: Seventy-eight strains were identified as resistant to at least one carbapenem; these CRKP strains had a high prevalence rate (38.5%, 30/78) of carbapenemase producers. Additionally, most isolates harbored MDR genes, including Extended spectrum β-lactamases (ESBLs), AmpC, and quinolone and aminoglycoside resistance genes. Loss of porin genes was observed, and Class 1 integron was detected in 66.7% of the investigated isolates. PFGE and MLST results excluded the occurrence of clonal dissemination among these isolates. CONCLUSIONS: A high prevalence of NDM-1 genes encoding carbapenem resistance determinants was demonstrated among the K. pneumoniae isolates. Importantly, this is the first report of bla(NDM-1) carriage in a K. pneumoniae ST1383 clone in China and of a MDR CRKP isolate co-harboring bla(NDM-1), bla(KPC-2), bla(CTX-M), bla(SHV), acc(6')-Ib, rmtB, qnrB, and acc(6')-Ib-cr. SN - 2234-3814 UR - https://www.unboundmedicine.com/medline/citation/28643488/Multidrug_Resistance_Mechanisms_of_Carbapenem_Resistant_Klebsiella_pneumoniae_Strains_Isolated_in_Chongqing_China_ L2 - http://www.annlabmed.org/journal/viewJournal.html?year=2017&vol=37&page=398 DB - PRIME DP - Unbound Medicine ER -