Dissemination and characteristics of carbapenem-resistant <i>Klebsiella pneumoniae</i> in nine district hospitals in southwestern China

作者全名："Wang, Yonghong; Ouyang, Yan; Xu, Xiuyu; Sun, Shan; Tian, Xiaolang; Liu, Hang; Xia, Yun"

作者地址："[Wang, Yonghong] Chongqing Univ, Chongqing Qianjiang Cent Hosp, Qianjiang Hosp, Dept Clin Lab, Chongqing, Peoples R China; [Wang, Yonghong] Qianjiang Key Lab Chongqing Qianjiang Cent Hosp La, Dept Lab Med, Chongqing, Peoples R China; [Wang, Yonghong; Xu, Xiuyu; Sun, Shan; Xia, Yun] Chongqing Med Univ, Affiliated Hosp 1, Dept Lab Med, Chongqing, Peoples R China; [Ouyang, Yan] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Nursing, Wuhan, Peoples R China; [Tian, Xiaolang] Fifth Peoples Hosp Chongqing, Dept Clin Lab, Chongqing, Peoples R China; [Liu, Hang] Wuhan Univ, Inst Translat Med, Renmin Hosp, Dept Clin Lab, Wuhan, Peoples R China"

通信作者："Xia, Y (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Lab Med, Chongqing, Peoples R China.; Liu, H (通讯作者)，Wuhan Univ, Inst Translat Med, Renmin Hosp, Dept Clin Lab, Wuhan, Peoples R China."

来源：FRONTIERS IN MICROBIOLOGY

ESI学科分类：MICROBIOLOGY

WOS号：WOS:001099212800001

JCR分区：Q2

影响因子：4

年份：2023

卷号：14

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：CRKP; district hospitals; dissemination and characteristics; HV-CRKP; resistance mechanisms

摘要："Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is epidemically transmitted globally, but few studies focused on the prevalence in district-level hospitals. In this study, we investigated CRKP strains collected from nine district hospitals from September 2019 to September 2020, aiming to determine the resistance mechanisms, virulence profiles, and molecular epidemiological characteristics of CRKP in district hospitals in Southwest China. Methods: A total of 51 CRKP strains were collected from 9 district-level hospitals. Matrix-assisted laser desorption/ionization-time of flight mass spectrometer was used for strain identification review, and the micro-broth dilution method was used for antibiotic sensitivity detection. Molecular epidemiological investigation of strains was performed by multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) methods. PCR and efflux pump inhibition tests were used to detect CRKP resistance mechanisms. PCR and serum killing tests were used to detect capsular serotype, virulence-related genes, and virulence validation. Results: The CRKP strains in district hospitals presented high levels of MIC50 and MIC90 in carbapenem antibiotics especially ertapenem and meropenem. A total of 90.2% (46/51) CRKP strains were detected as carbapenemase producers, and the proportion of strains co-expressing carbapenemases was 11.8% (6/51). All CRKP strains were grouped into eight MLST types, and ST11 was the most prevalent genotype. A total of 11.8% (6/51) CRKP isolates were positive for the string test, and three strains of hypervirulent and carbapenem-resistant K. pneumoniae (HV-CRKP) were positive in serum killing test. The molecular typing of all the CRKP isolates was grouped into 29 different PFGE patterns, and 40 ST11 isolates belonged to 20 different PFGE clusters. Conclusion: CRKP strains showed high-level antibiotic resistance and virulence phenotype in district hospitals in Southwest China, which suggested that we should immediately pay attention to the rapid dissemination of the CRKP in regional hospitals. Our study will provide new insights into the epidemiology of CRKP in regional hospitals, which will help regional hospitals develop nosocomial infection prevention and control policies tailored to local conditions."

基金机构："The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported in part by the National Natural Science Foundation of China (Grant No. X1919XYTSC) and Chongqing Medical Scienti [X1919XYTSC]; National Natural Science Foundation of China [2018MSXM104]; Chongqing Medical Scientific Research Project (Joint project of Chongqing Health Commission and Science and Technology Bureau)"

基金资助正文："We thank all the participants for providing the available data.r The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported in part by the National Natural Science Foundation of China (Grant No. X1919XYTSC) and Chongqing Medical Scientific Research Project (Joint project of Chongqing Health Commission and Science and Technology Bureau) (Grant No. 2018MSXM104)."