High Prevalence of KPC-2-Type Carbapenemase Coupled with CTX-M-Type Extended-Spectrum β-Lactamases in Carbapenem-Resistant Klebsiella pneumoniae in a Teaching Hospital in China

Chen, Shudan; Hu, Fupin; Xu, Xiaogang; Liu, Yang; Wu, Wei; Zhu, Demei; Wang, Honghai

doi:10.1128/aac.00047-11

Cited by 59 publications

(53 citation statements)

References 8 publications

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“…Most (80·4%) isolates expressed carbapenemase genes and similar to previous reports on Enterobacteriaceae in China [25,26], 54·9% of the isolates in this study harboured bla KPC-2 . In China, bla NDM-1 expression has been identified mainly for Actinetobacter spp.…”

Section: Resultssupporting

confidence: 88%

The prevalence of carbapenemase genes and plasmid-mediated quinolone resistance determinants in carbapenem-resistant Enterobacteriaceae from five teaching hospitals in central China

Zhong

Shang

et al. 2013

Epidemiol. Infect.

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We investigated the prevalence of β-lactamase genes and plasmid-mediated quinolone resistance (PMQR) determinants in 51 carbapenem-resistant Enterobacteriaceae (CRE) from five teaching hospitals in central China. The prevalence of carbapenem resistance in Enterobacteriaceae was 1·0% (51/5012). Of 51 CRE, 31 (60·8%) isolates were positive for one tested carbapenemase gene, while 10 (19·6%) were simultaneously positive for two tested carbapenemase genes. The positive rates of bla KPC-2, bla NDM-1, bla IMP-4, bla IMP-26 and bla IMP-8 were 54·9%, 17·6%, 11·8%, 11·8% and 3·9%, respectively. Of 10 CRE with two carbapenemase genes, three, five, one and one were positive for bla KPC-2 and bla IMP-4, bla KPC-2 and bla IMP-26, bla KPC-2 and bla IMP-8, and bla KPC-2 and bla NDM-1, respectively. Eight of nine bla NDM-1-positive isolates lacked carbapenemases by the modified Hodge test, while 27/28 isolates harbouring bla KPC-2 were positive for carbapenemases determined by this test; 41·2% of the CRE-positive isolates also harboured ESBL genes in various combinations (three and two positive for bla KPC-2 also carried bla DHA-1 and bla CMY-2). The positive rates of qnrS1, qnrA1, qnrB and aac-(6/)-Ib-cr in CRE were 25·5%, 9·8%, 23·5% and 15·7%, respectively. In particular, 7/9 isolates harbouring bla NDM-1 were positive for these quinolone resistance genes, of which five carried qnrS1 and two carried qnrS1 and qnrB4. All but two of 29 Klebsiella pneumoniae isolates were grouped into 20 clonal clusters by PFGE, with the predominant cluster accounting for four bla KPC-2-positive isolates distributed in the same hospital. We conclude that there is a high prevalence of bla NDM-1 and PMQR determinants in CRE isolates in central China. Multiple resistance determinants in various combinations co-exist in these strains and we report for the first time the co-existence of bla KPC-2 and bla IMP-26 in a strain of Klebsiella oxytoca.

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Section: Resultssupporting

confidence: 88%

The prevalence of carbapenemase genes and plasmid-mediated quinolone resistance determinants in carbapenem-resistant Enterobacteriaceae from five teaching hospitals in central China

Zhong

Shang

et al. 2013

Epidemiol. Infect.

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“…The emergence and dissemination of ESBL and carbapenemase genes in K. pneumoniae isolates worldwide poses a considerable threat to public health (17,18). The detection rate of ESBL-producing K. pneumoniae dropped from 47.9% in 2009 to 31.3% in 2014.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Susceptibility and Molecular Epidemiology of Multidrug-Resistant <i>Klebsiella pneumoniae</i> in Central China

et al. 2017

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“…In this study, 3 (6.7%) adults and 2 (5.3%) infants were KPC positive. In a research in China, the results revealed that 70.6% (77/109) of K. pneumoniae were KPC positive and 59.6% (65/109) of isolates were ESBL + KPC positive (Chen et al, 2011b). A study showed two patients with multidrug-resistant KPC-carbapenemase-producing K. pneumoniae urinary tract infections (Virgincar et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Identification of extended-spectrum-beta-lactamases(ESBLs), metallo-beta-lactamases (MBLs), Amp-C and KPC -lactamases among Klebsiella pneumoniae isolated from adults and pediatric patients in Iran

Fallah¹,

Mojdeh²,

Goudarzi³

et al. 2013

Afr. J. Microbiol. Res.

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Klebsiella pneumoniae is one of the major bacteria that cause acute infections. β-lactamases are main defensive mechanisms in bacteria against drugs. The aim of this study was to determine antibiotic resistance patterns and detection of extended-spectrum-beta-lactamase (ESBL), MBL, Amp-C and KPC β-lactamases among K. pneumoniae strains isolated from adults and infants. This descriptive study was done on 83 K. pneumoniae isolated from two hospitals. Antibiotic susceptibility tests were performed by Kirby-Bauer disc diffusion and broth microdilution methods according to Clinical Laboratory Standards Institute (CLSI) guidelines. ESBLs, MBL, Amp-C and KPC producing strains were detected by phenotypic confirmatory test, combination disk diffusion test (CDDT), Amp-C detection kit and Modified Hodge test, respectively. From 83 K. pneumoniae strains, 48 (57.5%), 3 (3.5%), 23 (28%) and 5 (6%) were ESBL, MBL, Amp-C and KPC positive, respectively. In this study, Fosfomycin and Tigecycline were more active than other antibiotics. The results demonstrated that incidence of ESBLs, Amp-C, MBLs and KPC was critical especially in infants. Therefore, detection of drug resistance patterns in K. pneumoniae and β-lactamases producing isolates is important for the prevention and control of these infections.

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High Prevalence of KPC-2-Type Carbapenemase Coupled with CTX-M-Type Extended-Spectrum β-Lactamases in Carbapenem-Resistant Klebsiella pneumoniae in a Teaching Hospital in China

Cited by 59 publications

References 8 publications

The prevalence of carbapenemase genes and plasmid-mediated quinolone resistance determinants in carbapenem-resistant Enterobacteriaceae from five teaching hospitals in central China

The prevalence of carbapenemase genes and plasmid-mediated quinolone resistance determinants in carbapenem-resistant Enterobacteriaceae from five teaching hospitals in central China

Antimicrobial Susceptibility and Molecular Epidemiology of Multidrug-Resistant <i>Klebsiella pneumoniae</i> in Central China

Identification of extended-spectrum-beta-lactamases(ESBLs), metallo-beta-lactamases (MBLs), Amp-C and KPC -lactamases among Klebsiella pneumoniae isolated from adults and pediatric patients in Iran

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