Clonal replacement of epidemic KPC-producing Klebsiella pneumoniae in a hospital in China

BMC Infectious Diseases

Research Article

Yuying Liang¹  Xiuyun Yin¹  Shuiping Chen¹  Lijun Zeng¹ 

[1] Department of Laboratory Medicine, Affiliated hospital of Academy of Military Medical Sciences, Beijing, People’s Republic of China;

关键词: Klebsiella pneumoniae;    Carbapenemase;    Clonal replacement;    Epidemiology;    Antimicrobial resistance;   

DOI  :  10.1186/s12879-017-2467-9

 received in 2016-10-19, accepted in 2017-05-16,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundKlebsiella pneumoniae is a frequent nosocomial pathogen causing difficult-to-treat infections worldwide. The prevalence of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (KPC-KP) is increasing in China. The aim of this study was to investigate the molecular epidemiology of KPC-KP in a nosocomial outbreak.MethodsFifty-four KPC-KP isolates were consecutively collected between November 2013 and August 2014 during a KPC-KP outbreak in a tertiary care hospital in Beijing, China. Antimicrobial susceptibility was determined by agar dilution. Carbapenemase, extended-spectrum β–lactamase, 16S rRNA methylase, AmpC β-lactamase, and plasmid-mediated quinolone resistance determinants were detected by PCR amplification. The genetic relatedness of isolates was analyzed by pulsed-field gel electrophoresis and multi-locus sequence typing.ResultsAll isolates belonged to ST11 except one isolate which was identified as a new sequence type (ST2040). PFGE profile of genomic DNA revealed seven clusters, of which cluster A and C dominated the KPC-KP outbreak and cluster A was replaced by cluster C during the outbreak. PFGE of genomic DNA, S1-PFGE of plasmids, replicon typing, and drug resistant characteristics showed that clonal spread occurred during the outbreak. When compared with isolates within cluster A, all isolates in cluster C harbored rmtB and showed higher level of resistance to cefepime, amikacin, tobramycin, and tigecycline.ConclusionWe reported a nosocomial outbreak of KPC-KP with clonal replacement and a new sequence type (ST2040) of KP. High degree of awareness and surveillance of KPC-KP should be given to avoid potential outbreaks, especially in ICU wards.

【 授权许可】

CC BY   
© The Author(s). 2017