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Shift in the dominant sequence type of carbapenem-resistant Klebsiella pneumonia infection from ST278-NDM-1 to ST11-KPC-2 in neonatal patients in a children's hospital in Shanghai, China, 2017-2021.
- Source :
-
International microbiology : the official journal of the Spanish Society for Microbiology [Int Microbiol] 2024 Jun; Vol. 27 (3), pp. 871-881. Date of Electronic Publication: 2023 Oct 19. - Publication Year :
- 2024
-
Abstract
- Objectives: To investigate the clinical characteristics and molecular epidemiology of CRKP infection in neonatal patients in a children's hospital in China from 2017 to 2021.<br />Methods: Species identification and antibiotic susceptibilities were tested with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and VITEK 2 systems. The clinical data were collected from medical records. Carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates were investigated by antimicrobial susceptibility testing, carbapenemase genes and multilocus sequence typing.<br />Results: Six kinds of resistant genes and 23 STs were detected. Bla <subscript>NDM-1</subscript> (n=83, 55.3%) was the predominant carbapenemase gene, followed by bla <subscript>KPC-2</subscript> (n=45, 30.0%), bla <subscript>NDM-5</subscript> (n=7, 4.7%), bla <subscript>IMP-38</subscript> (n=6, 4.0%). Bla <subscript>NDM-1</subscript> was predominant in 2017 and 2018, whereas bla <subscript>KPC-2</subscript> increased in 2019 and became the predominant gene from 2020 to 2021. ST11 accounted for most infections (n=35, 23.3%), followed by ST278 (n=23, 15.3%), ST17 (n=17, 11. 3%) and ST2735 (n=16, 10.7%). ST278 and ST17 were predominant in 2017 and 2018, whereas ST11 increased in 2019 and became the predominant sequence type from 2020 to 2021. Compared with bla <subscript>NDM-1</subscript> , the CRKP strains producing bla <subscript>KPC-2</subscript> were characterized by high resistance to gentamicin, amikacin and levofloxacin and the change trend of drug resistance rate before and after COVID-19 was consistent with that of bla <subscript>NDM-1</subscript> and bla <subscript>KPC-2</subscript> .<br />Conclusions: The main sequence type of CRKP infection changed dynamically from ST278-NDM-1 to ST11-KPC-2 during the years 2017-2021 in the newborns. Antibiotic exposure and the prevalence of COVID-19 since 2020 may have led to changes in hospital population and lead to the changes.<br /> (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
- Subjects :
- Humans
China epidemiology
Infant, Newborn
Male
Female
Bacterial Proteins genetics
Bacterial Proteins metabolism
Carbapenem-Resistant Enterobacteriaceae genetics
Carbapenem-Resistant Enterobacteriaceae drug effects
Carbapenem-Resistant Enterobacteriaceae isolation & purification
Molecular Epidemiology
Infant
Drug Resistance, Multiple, Bacterial genetics
Klebsiella pneumoniae genetics
Klebsiella pneumoniae drug effects
Klebsiella pneumoniae isolation & purification
Klebsiella pneumoniae enzymology
beta-Lactamases genetics
beta-Lactamases metabolism
Klebsiella Infections microbiology
Klebsiella Infections epidemiology
Klebsiella Infections drug therapy
Anti-Bacterial Agents pharmacology
Microbial Sensitivity Tests
Multilocus Sequence Typing
Hospitals, Pediatric
Carbapenems pharmacology
Subjects
Details
- Language :
- English
- ISSN :
- 1618-1905
- Volume :
- 27
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- International microbiology : the official journal of the Spanish Society for Microbiology
- Publication Type :
- Academic Journal
- Accession number :
- 37857932
- Full Text :
- https://doi.org/10.1007/s10123-023-00436-z