Carbapenemase-Producing Enterobacteriaceae in South Korea: A Report from the National Laboratory Surveillance System

Yoon, Eunju; Yang, Jiyeon; Kim, Jung O.K.; Lee, Hyukmin; Lee, Kwang Jun; Jeong, Seok Hoon

doi:10.2217/fmb-2018-0022

Cited by 50 publications

(31 citation statements)

References 27 publications

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“…There is a limited number of large-scale studies that have examined the clonal background of NDM-producing strains. These include one study involving multiple nations (62), one study across three countries (63), three studies conducted at a national level (38,64,65), and two municipal-level studies (66, 67) (see Table S2 in the supplemental material). While studying genomes deposited in GenBank can result in inherent bias, it is also the most comprehensive approach available to provide additional insights into the clonal background of NDM-positive strains.…”

Section: Clonal Background Of Ndm-positive Strainsmentioning

confidence: 99%

“…In the literature, ST14 is repeatedly reported as one of the most common types of NDMpositive K. pneumoniae strains (63-65). ST11 is another common type in multiple studies (38,(63)(64)(65). Of note, ST11 is the predominant ST of carbapenem-resistant K. pneumoniae in China but mainly carries KPC-2 rather than NDM (76).…”

Section: Clonal Background Of Ndm-positive Strainsmentioning

confidence: 99%

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NDM Metallo-β-Lactamases and Their Bacterial Producers in Health Care Settings

et al. 2019

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SUMMARYNew Delhi metallo-β-lactamase (NDM) is a metallo-β-lactamase able to hydrolyze almost all β-lactams. Twenty-four NDM variants have been identified in >60 species of 11 bacterial families, and several variants have enhanced carbapenemase activity.Klebsiella pneumoniaeandEscherichia coliare the predominant carriers ofblaNDM, with certain sequence types (STs) (forK. pneumoniae, ST11, ST14, ST15, or ST147; forE. coli, ST167, ST410, or ST617) being the most prevalent. NDM-positive strains have been identified worldwide, with the highest prevalence in the Indian subcontinent, the Middle East, and the Balkans. MostblaNDM-carrying plasmids belong to limited replicon types (IncX3, IncFII, or IncC). Commonly used phenotypic tests cannot specifically identify NDM. Lateral flow immunoassays specifically detect NDM, and molecular approaches remain the reference methods for detectingblaNDM. Polymyxins combined with other agents remain the mainstream options of antimicrobial treatment. Compounds able to inhibit NDM have been found, but none have been approved for clinical use. Outbreaks caused by NDM-positive strains have been reported worldwide, attributable to sources such as contaminated devices. Evidence-based guidelines on prevention and control of carbapenem-resistant Gram-negative bacteria are available, although none are specific for NDM-positive strains. NDM will remain a severe challenge in health care settings, and more studies on appropriate countermeasures are required.

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Section: Clonal Background Of Ndm-positive Strainsmentioning

confidence: 99%

Section: Clonal Background Of Ndm-positive Strainsmentioning

confidence: 99%

NDM Metallo-β-Lactamases and Their Bacterial Producers in Health Care Settings

et al. 2019

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“…Considering that carbapenem is one of the antibiotics used as a last resort to beat multidrug-resistant Gram-negative bacteria, increase in the proportion of carbapenem usage is a worrisome finding. In South Korea, the increase in the incidence of carbapenem resistant Enterobactericeae (CRE) carriage has become a serious problem [ 30 ]. To curb the vicious cycle, antimicrobial stewardship and prescription control of broad-spectrum antibiotics for the treatment of common but not serious infections, such as CA-APN, should be reinforced.…”

Section: Discussionmentioning

confidence: 99%

Changes in Clinical Characteristics of Community-Acquired Acute Pyelonephritis and Antimicrobial Resistance of Uropathogenic Escherichia coli in South Korea in the Past Decade

et al. 2020

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This study examined changes in the clinical characteristics of community-acquired acute pyelonephritis (CA-APN) in South Korea between the period 2010–2011 and 2017–2018. We recruited all CA-APN patients aged ≥19 years who visited eight hospitals in South Korea from September 2017 to August 2018, prospectively. Data collected were compared with those from the previous study in 2010–2012, with the same design and participation from 11 hospitals. A total of 617 patients were enrolled and compared to 818 patients’ data collected in 2010–2011. Escherichia coli was the most common causative pathogen of CA-APN in both periods (87.3% vs. 86.5%, p = 0.680). E. coli isolates showed significantly higher antimicrobial resistance against fluoroquinolone (32.0% vs. 21.6%, p < 0.001), cefotaxime (33.6% vs. 8.3%, p < 0.001), and trimethoprim/sulfamethoxazole (37.5% vs. 29.2%, p = 0.013) in 2017–2018 than in 2010–2011. Total duration of antibiotic treatment increased from 16.55 ± 9.68 days in 2010–2011 to 19.12 ± 9.90 days in 2017–2018 (p < 0.001); the duration of carbapenem usage increased from 0.59 ± 2.87 days in 2010–2011 to 1.79 ± 4.89 days in 2010–2011 (p < 0.001). The median hospitalization was higher for patients in 2017–2018 than in 2010–2011 (9 vs. 7 days, p < 0.001). In conclusion, antimicrobial resistance of E. coli to almost all antibiotic classes, especially third generation cephalosporin, increased significantly in CA-APN in South Korea. Consequently, total duration of antibiotic treatment, including carbapenem usage, increased.

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“…In recent years, the spectrum of resistance of the K. pneumoniae ST307 clone was broadened to carbapenems by acquiring genes encoding carbapenemases, such as KPC ( Villa et al, 2017 ). The KPC-producing K. pneumoniae clonal group (CG) has been changed from CG235 to ST307 in recent years ( Yoon et al, 2018b ; Cejas et al, 2019 ). In South Korea, most of the KPC-producing Enterobacterales were K. pneumoniae ST11 belonging to CG235 until 2014 and from 2015, the KPC-producing clone was rapidly exchanged to ST307 ( Yoon et al, 2018b ).…”

Section: Introductionmentioning

confidence: 99%

A Novel KPC Variant KPC-55 in Klebsiella pneumoniae ST307 of Reinforced Meropenem-Hydrolyzing Activity

et al. 2020

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A novel Klebsiella pneumoniae carbapenemase (KPC) variant, KPC-55, produced by a K. pneumoniae ST307 strain was characterized. K. pneumoniae strain BS407 was recovered from an active surveillance rectal swab of a patient newly admitted to a general hospital in Busan, South Korea. Carbapenemase production was confirmed by the modified Hodge test, and the MICs of β-lactams were determined by the broth microdilution method. The whole genome was sequenced. Cloning and expression of the bla KPC–55 gene in Escherichia coli and MIC determination were performed. The enzyme KPC-55 was used for kinetic assays against β-lactams and compared with the KPC-2 enzyme. The new allele of the bla KPC gene had a T794A alteration compared to the bla KPC–2 gene, resulting in the amino acid substitution Y264N in the middle of the β9-sheet. Compared to the KPC-2-producing strain, the KPC-55-producing strain exhibited a lower level of resistance to most β-lactam drugs tested, however, the KPC-55 enzyme catalyzed aztreonam and meropenem at an increased efficiency compared to the catalytic activity of KPC-2. KPC subtypes could have varied phenotypes due to alterations in amino acid sequences, and such an unexpected resistance phenotype emphasizes the importance of detailed characterizations for the carbapenemase-producing Enterobacterales.

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Carbapenemase-Producing Enterobacteriaceae in South Korea: A Report from the National Laboratory Surveillance System

Abstract: The nation-wide spreads of KPC, NDM and OXA-48-like CPEs were in an alarming epidemiological stage.

Cited by 50 publications

References 27 publications

NDM Metallo-β-Lactamases and Their Bacterial Producers in Health Care Settings

NDM Metallo-β-Lactamases and Their Bacterial Producers in Health Care Settings

Changes in Clinical Characteristics of Community-Acquired Acute Pyelonephritis and Antimicrobial Resistance of Uropathogenic Escherichia coli in South Korea in the Past Decade

A Novel KPC Variant KPC-55 in Klebsiella pneumoniae ST307 of Reinforced Meropenem-Hydrolyzing Activity

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