First description of NDM-1-, KPC-2-, VIM-2- and IMP-4-producing Klebsiella pneumoniae strains in a single Chinese teaching hospital.
A total of 180 non-duplicate carbapenem-resistant Klebsiella pneumoniae isolates were recovered from patients hospitalized between December 2010 and January 2012 at a Chinese hospital. Eight KPC-2, four NDM-1, one VIM-2, and five KPC-2 plus IMP-4 producers were identified and all were multidrug resistant due to the presence of other resistance determinants, including extended-spectrum β-lactamases (CTX-M-15, SHV-12), 16S rRNA methylases (armA, rmtB) and plasmid-mediated quinolone-resistance determinants (qnrA, B, S, aac(6')-Ib-cr). Nine K. pneumoniae clones (Kpn-A1/ST395, Kpn-A3/ST11, Kpn-A2/ST134, Kpn-B/ST263, Kpn-C/ST37, Kpn-D/ST39, Kpn-E/ST1151, Kpn-F/ST890, Kpn-G/ST1153) were identified. bla KPC-2 was located on transferable ~65 kb IncL/M (ST395, ST11, ST134, ST39) and ~100 kb IncA/C (ST37, ST1153, ST890) plasmids, respectively. On the other hand, bla NDM-1 was associated with a ~70 kb IncA/C plasmid (ST263). However, non-typable plasmids of ~40 kb containing bla VIM-2 were detected in the ST1151 clone. This work reports the first co-occurrence of four diverse types of carbapenemase of K. pneumoniae clones from a single hospital in China. IncA/C, IncL/M, and other successful plasmids may be important for the dissemination of carbapenemases, producing a complex epidemiological picture.
Department of Clinical Microbiology,First Affiliated Hospital of Nanchang University,Nanchang University, Nanchang, PRChina.
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Liu
Department of Clinical Microbiology,First Affiliated Hospital of Nanchang University,Nanchang University, Nanchang, PRChina.
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Wan
Department of Infection Control,First Affiliated Hospital of Nanchang University,Nanchang University, Nanchang, PRChina.
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Deng
Department of Infection Control,First Affiliated Hospital of Nanchang University,Nanchang University, Nanchang, PRChina.
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Cao
Department of Clinical Microbiology,First Affiliated Hospital of Nanchang University,Nanchang University, Nanchang, PRChina.
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Yu
Department of Clinical Microbiology,First Affiliated Hospital of Nanchang University,Nanchang University, Nanchang, PRChina.
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Xu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002681:China / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017720:Molecular Epidemiology; D058885:Multilocus Sequence Typing; D001618:beta-Lactamases / Q000235:genetics*
D000900:Anti-Bacterial Agents; D001618:beta-Lactamases