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Dynamic Epidemiology and Virulence Characteristics of Carbapenem-Resistant Klebsiella pneumoniae in Wenzhou, China from 2003 to 2016.
Infect Drug Resist. 2020; 13:931-940.ID

Abstract

Purpose

To investigate transitions in resistance mechanisms, virulence characteristics and molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae (CRKP) during 2003-2016 in a major Eastern Chinese medical center.

Patients and Methods

From a total of 2299 K. pneumoniae clinical strains collected from 2003 to 2016, 214 were found to be CRKP isolates and were selected for further study. Characterization of these was conducted by molecular detection of antibiotic resistance markers and virulence determinants, modified carbapenem inactivation method and multilocus sequence typing (MLST).

Results

In this study, the prevalence of CRKP was increasing over the 14-year period, mirroring a national trend. These CRKP strains were resistant to most of the tested, clinically relevant drugs. The majority of these CRKP strains were positive for carbapenemases, with the Klebsiella pneumoniae carbapenemase (KPC) found to be the dominant type (207/210, 98.6%). The carrier rates of virulence genes uge, entB, fimH, mrkD and ureA increased in 2016, while the ybtA, iucA and irp2 showed a relatively constant trend. From MLST data, ST11 (88.8%, 190/214) was the preponderant sequence type (ST), followed by ST15 (1.9%, 4/214) and ST656 (1.4%, 3/214). Several strains with less common STs (ST690, ST895, ST1823 and ST1384) were also detected, and these too showed high levels of antimicrobial resistance.

Conclusion

The average national rise in CRKP across China is mirrored in this in-depth analysis of a single hospital, while the prevalence of hypervirulent CRKP (such as ST15) was relatively low as of 2016. Continuous monitoring is necessary to keep track of CRKP and should include the prospect of newly emerging strains with less common STs and the prospect of detecting carbapenem-resistant, carbapenemase-negative Klebsiella pneumoniae.

Authors+Show Affiliations

Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China. School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, People's Republic of China.Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.Infection and Immunity Program, Biomedicine Discovery Institute and Department of Microbiology, Monash University, Melbourne, VIC, Australia.School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, People's Republic of China.Infection and Immunity Program, Biomedicine Discovery Institute and Department of Microbiology, Monash University, Melbourne, VIC, Australia.Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32280249

Citation

Zhao, Yajie, et al. "Dynamic Epidemiology and Virulence Characteristics of Carbapenem-Resistant Klebsiella Pneumoniae in Wenzhou, China From 2003 to 2016." Infection and Drug Resistance, vol. 13, 2020, pp. 931-940.
Zhao Y, Zhang S, Fang R, et al. Dynamic Epidemiology and Virulence Characteristics of Carbapenem-Resistant Klebsiella pneumoniae in Wenzhou, China from 2003 to 2016. Infect Drug Resist. 2020;13:931-940.
Zhao, Y., Zhang, S., Fang, R., Wu, Q., Li, J., Zhang, Y., Rocker, A., Cao, J., Lithgow, T., & Zhou, T. (2020). Dynamic Epidemiology and Virulence Characteristics of Carbapenem-Resistant Klebsiella pneumoniae in Wenzhou, China from 2003 to 2016. Infection and Drug Resistance, 13, 931-940. https://doi.org/10.2147/IDR.S243032
Zhao Y, et al. Dynamic Epidemiology and Virulence Characteristics of Carbapenem-Resistant Klebsiella Pneumoniae in Wenzhou, China From 2003 to 2016. Infect Drug Resist. 2020;13:931-940. PubMed PMID: 32280249.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dynamic Epidemiology and Virulence Characteristics of Carbapenem-Resistant Klebsiella pneumoniae in Wenzhou, China from 2003 to 2016. AU - Zhao,Yajie, AU - Zhang,Siqin, AU - Fang,Renchi, AU - Wu,Qing, AU - Li,Jiahui, AU - Zhang,Yizhi, AU - Rocker,Andrea, AU - Cao,Jianming, AU - Lithgow,Trevor, AU - Zhou,Tieli, Y1 - 2020/03/31/ PY - 2019/12/19/received PY - 2020/03/03/accepted PY - 2020/4/14/entrez PY - 2020/4/14/pubmed PY - 2020/4/14/medline KW - Klebsiella pneumoniae KW - ST11 KW - antimicrobial resistance KW - carbapenem-resistant KW - epidemiology SP - 931 EP - 940 JF - Infection and drug resistance JO - Infect Drug Resist VL - 13 N2 - Purpose: To investigate transitions in resistance mechanisms, virulence characteristics and molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae (CRKP) during 2003-2016 in a major Eastern Chinese medical center. Patients and Methods: From a total of 2299 K. pneumoniae clinical strains collected from 2003 to 2016, 214 were found to be CRKP isolates and were selected for further study. Characterization of these was conducted by molecular detection of antibiotic resistance markers and virulence determinants, modified carbapenem inactivation method and multilocus sequence typing (MLST). Results: In this study, the prevalence of CRKP was increasing over the 14-year period, mirroring a national trend. These CRKP strains were resistant to most of the tested, clinically relevant drugs. The majority of these CRKP strains were positive for carbapenemases, with the Klebsiella pneumoniae carbapenemase (KPC) found to be the dominant type (207/210, 98.6%). The carrier rates of virulence genes uge, entB, fimH, mrkD and ureA increased in 2016, while the ybtA, iucA and irp2 showed a relatively constant trend. From MLST data, ST11 (88.8%, 190/214) was the preponderant sequence type (ST), followed by ST15 (1.9%, 4/214) and ST656 (1.4%, 3/214). Several strains with less common STs (ST690, ST895, ST1823 and ST1384) were also detected, and these too showed high levels of antimicrobial resistance. Conclusion: The average national rise in CRKP across China is mirrored in this in-depth analysis of a single hospital, while the prevalence of hypervirulent CRKP (such as ST15) was relatively low as of 2016. Continuous monitoring is necessary to keep track of CRKP and should include the prospect of newly emerging strains with less common STs and the prospect of detecting carbapenem-resistant, carbapenemase-negative Klebsiella pneumoniae. SN - 1178-6973 UR - https://www.unboundmedicine.com/medline/citation/32280249/Dynamic_Epidemiology_and_Virulence_Characteristics_of_Carbapenem_Resistant_Klebsiella_pneumoniae_in_Wenzhou_China_from_2003_to_2016_ L2 - https://dx.doi.org/10.2147/IDR.S243032 DB - PRIME DP - Unbound Medicine ER -
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