title: The Resistance Phenotype and Molecular Epidemiology ofKlebsiella pneumoniaein Bloodstream Infections in Shanghai, China, 2012-2015.
abstract: Klebsiella pneumoniae(K.pneumoniae) is a common nosocomial pathogen causing bloodstream infections. Antibiotic susceptibility surveillance and molecular characterization will facilitate prevention and management ofK. pneumoniaebloodstream infections.K. pneumoniaeisolates causing bloodstream infections were consecutively collected between January 2012 and December 2015 in Shanghai. Eighty isolates (20 per year) were randomly selected and enrolled in this study. Drug susceptibility were determined by the disk diffusion method. Polymerase chain reaction (PCR) was employed to detect extended-spectrum β-lactamases (ESBLs), carbapenemases, and seven housekeeping genes ofK. pneumoniae. eBURST was used for multi-locus sequence typing (MLST). More than 50% isolates were resistant to cefuroxime, ampicillin-sulbactam, and piperacillin, while carbapenems had lower resistant rates than other antibiotics. Of the 80 isolates, 22 produced ESBLs, and 14 were carbapenemase producers. In the ESBL-producingK. pneumoniaeisolates, the most common ESBL genes wereblaSHVandblaCTX-M. Thirteen carbapenemase producers harboredblaKPC-2and one other carriedblaNDM-5. ST11 (14/80) was the most frequent sequence type (ST), followed by ST15 (7/80) and ST29 (4/80). Our data revealed high prevalence of antibiotic resistantK. pneumoniaeisolates from bloodstream infections but their genetic diversity suggested no clonal dissemination in the region. Also, oneK. pneumoniaeisolate harboredblaNDM-5in this study, which was firstly reported in Shanghai.
authors.affiliation: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, China.
authors.forename: Shu-Zhen
authors.initials: SZ
authors.lastname: Xiao
authors.affiliation: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, China.
authors.forename: Su
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Clinical Laboratory, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, China.
authors.forename: Wen-Man
authors.initials: WM
authors.lastname: Wu
authors.affiliation: Department of Clinical Laboratory, Xiangya Hospital, Central South University Changsha, China.
authors.forename: Sheng-Yuan
authors.initials: SY
authors.lastname: Zhao
authors.affiliation: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, China.
authors.forename: Fei-Fei
authors.initials: FF
authors.lastname: Gu
authors.affiliation: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, China.
authors.forename: Yu-Xing
authors.initials: YX
authors.lastname: Ni
authors.affiliation: Department of Medical Microbiology and Parasitology, Institutes of Medical Sciences, Shanghai Jiao Tong University School of Medicine Shanghai, China.
authors.forename: Xiao-Kui
authors.initials: XK
authors.lastname: Guo
authors.affiliation: Department of Pulmonary Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, China.
authors.forename: Jie-Ming
authors.initials: JM
authors.lastname: Qu
authors.affiliation: Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, China.
authors.forename: Li-Zhong
authors.initials: LZ
authors.lastname: Han
keywords: Klebsiella pneumoniae; bloodstream infections; extended-spectrum β-lactamase; molecular epidemiology; resistance phenotype