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Dissemination of Klebsiella pneumoniae ST11 isolates with carbapenem resistance in integrated and emergency intensive care units in a Chinese tertiary hospital.
J Med Microbiol 2019; 68(6):882-889JM

Abstract

PURPOSE

The aim of the present study was to investigate the dissemination of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates in integrated intensive care units (IICUs) and emergency ICUs (EICUs) for controlling the spread of CRKP in different ICUs of the hospital.

METHODOLOGY

From January 2016 to April 2017, a total of 46 non-duplicate CRKP isolates were consecutively isolated from a tertiary hospital. The production of carbapenemases was determined by the modified carbapenem inactivation method (mCIM) test. The resistance and virulence-associated genes were detected by PCR and DNA sequencing. A hypermucoviscosity phenotype was identified by the string test. Bacterial clonal relatedness of the CRKP isolates tested was determined by multi-locus sequence typing (MLST) and PFGE.

RESULTS

All CRKP isolates showed multiple drug resistance. All CRKP isolates harboured blaKPC-2-encoding carbapenemase and at least one of the other β-lactamase genes tested, with positive rates of 89.1 % (41/46) for blaCTX-M-65. qnrS was found among 76.1 % (35/46) of the CRKP isolates. A hypermucoviscosity phenotype was found in only two (4.3 %, 2/46) CRKP isolates. The virulence-associated genes with positive rates of more than 90 % among the 46 isolates tested included wabG (100 %, 46/46), ycf (100 %, 46/46), ureA (95.6 %, 44/46) and fim H (95.6 %, 44/46). MLST results showed that 46 CRKP isolates belonged to ST11 (95.6 %, 44/46) and ST86 (4.4 %, 2/46). PFGE patterns showed four clusters.

CONCLUSION

The CRKP ST11 clone with co-production of CTX-M-65 and KPC-2 disseminated in ICUs of this tertiary teaching hospital in central China. The emergence of CRKP with a hypermucoviscosity phenotype in ICUs should be of particular concern.

Authors+Show Affiliations

1 Department of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang Jiangxi Provincial Key Laboratory of Medicine, Nanchang 330006, PR China.1 Department of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang Jiangxi Provincial Key Laboratory of Medicine, Nanchang 330006, PR China.1 Department of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang Jiangxi Provincial Key Laboratory of Medicine, Nanchang 330006, PR China.1 Department of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang Jiangxi Provincial Key Laboratory of Medicine, Nanchang 330006, PR China.1 Department of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang Jiangxi Provincial Key Laboratory of Medicine, Nanchang 330006, PR China.1 Department of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang Jiangxi Provincial Key Laboratory of Medicine, Nanchang 330006, PR China.1 Department of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang Jiangxi Provincial Key Laboratory of Medicine, Nanchang 330006, PR China.1 Department of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang Jiangxi Provincial Key Laboratory of Medicine, Nanchang 330006, PR China.1 Department of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang Jiangxi Provincial Key Laboratory of Medicine, Nanchang 330006, PR China.1 Department of Laboratory Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang Jiangxi Provincial Key Laboratory of Medicine, Nanchang 330006, PR China.2 Department of Clinical Laboratory, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai 200443, PR China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31050634

Citation

Yu, Feng, et al. "Dissemination of Klebsiella Pneumoniae ST11 Isolates With Carbapenem Resistance in Integrated and Emergency Intensive Care Units in a Chinese Tertiary Hospital." Journal of Medical Microbiology, vol. 68, no. 6, 2019, pp. 882-889.
Yu F, Hu L, Zhong Q, et al. Dissemination of Klebsiella pneumoniae ST11 isolates with carbapenem resistance in integrated and emergency intensive care units in a Chinese tertiary hospital. J Med Microbiol. 2019;68(6):882-889.
Yu, F., Hu, L., Zhong, Q., Hang, Y., Liu, Y., Hu, X., ... Yu, F. (2019). Dissemination of Klebsiella pneumoniae ST11 isolates with carbapenem resistance in integrated and emergency intensive care units in a Chinese tertiary hospital. Journal of Medical Microbiology, 68(6), pp. 882-889. doi:10.1099/jmm.0.000981.
Yu F, et al. Dissemination of Klebsiella Pneumoniae ST11 Isolates With Carbapenem Resistance in Integrated and Emergency Intensive Care Units in a Chinese Tertiary Hospital. J Med Microbiol. 2019;68(6):882-889. PubMed PMID: 31050634.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dissemination of Klebsiella pneumoniae ST11 isolates with carbapenem resistance in integrated and emergency intensive care units in a Chinese tertiary hospital. AU - Yu,Feng, AU - Hu,Longhua, AU - Zhong,Qiaoshi, AU - Hang,Yaping, AU - Liu,Yanling, AU - Hu,Xiaoyan, AU - Ding,Hui, AU - Chen,Yanhui, AU - Xu,Xiuhua, AU - Fang,Xueyao, AU - Yu,Fangyou, Y1 - 2019/05/03/ PY - 2019/5/6/pubmed PY - 2019/6/14/medline PY - 2019/5/4/entrez KW - Dissemination KW - KPC-2 KW - Klebsiella pneumoniae KW - ST11 KW - carbapenem resistance SP - 882 EP - 889 JF - Journal of medical microbiology JO - J. Med. Microbiol. VL - 68 IS - 6 N2 - PURPOSE: The aim of the present study was to investigate the dissemination of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates in integrated intensive care units (IICUs) and emergency ICUs (EICUs) for controlling the spread of CRKP in different ICUs of the hospital. METHODOLOGY: From January 2016 to April 2017, a total of 46 non-duplicate CRKP isolates were consecutively isolated from a tertiary hospital. The production of carbapenemases was determined by the modified carbapenem inactivation method (mCIM) test. The resistance and virulence-associated genes were detected by PCR and DNA sequencing. A hypermucoviscosity phenotype was identified by the string test. Bacterial clonal relatedness of the CRKP isolates tested was determined by multi-locus sequence typing (MLST) and PFGE. RESULTS: All CRKP isolates showed multiple drug resistance. All CRKP isolates harboured blaKPC-2-encoding carbapenemase and at least one of the other β-lactamase genes tested, with positive rates of 89.1 % (41/46) for blaCTX-M-65. qnrS was found among 76.1 % (35/46) of the CRKP isolates. A hypermucoviscosity phenotype was found in only two (4.3 %, 2/46) CRKP isolates. The virulence-associated genes with positive rates of more than 90 % among the 46 isolates tested included wabG (100 %, 46/46), ycf (100 %, 46/46), ureA (95.6 %, 44/46) and fim H (95.6 %, 44/46). MLST results showed that 46 CRKP isolates belonged to ST11 (95.6 %, 44/46) and ST86 (4.4 %, 2/46). PFGE patterns showed four clusters. CONCLUSION: The CRKP ST11 clone with co-production of CTX-M-65 and KPC-2 disseminated in ICUs of this tertiary teaching hospital in central China. The emergence of CRKP with a hypermucoviscosity phenotype in ICUs should be of particular concern. SN - 1473-5644 UR - https://www.unboundmedicine.com/medline/citation/31050634/Dissemination_of_Klebsiella_pneumoniae_ST11_isolates_with_carbapenem_resistance_in_integrated_and_emergency_intensive_care_units_in_a_Chinese_tertiary_hospital_ L2 - http://jmm.microbiologyresearch.org/pubmed/content/journal/jmm/10.1099/jmm.0.000981 DB - PRIME DP - Unbound Medicine ER -