Molecular characteristics of carbapenemase-producing Enterobacteriaceae in China from 2008 to 2011: Predominance of KPC-2 enzyme

Li, Henan; Zhang, Jixia; Liu, Yingmei; Zheng, Rui; Chen, Hongbin; Wang, Xiaojuan; Wang, Zhanwei; Cao, Bin; Wang, Hui

doi:10.1016/j.diagmicrobio.2013.10.002

Cited by 57 publications

(43 citation statements)

References 16 publications

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“…A previous study demonstrated that biapenem is as effective and well tolerated as imipenem/cilastatin in the treatment of intermediate and severe bacterial infections (11). A small number of carbapenem-resistant E. coli isolates have emerged in China (12,13). Our previous study showed that two resistance mechanisms involved in carbapenem-resistant enterobacteriaceae isolates included the production of carbapenemases and the loss or decreased expression of outer membrane proteins, in combination with the production of AmpC or ESBL enzymes (13).…”

Section: Discussionmentioning

confidence: 99%

In Vitro Analysis of Activities of 16 Antimicrobial Agents against Gram-Negative Bacteria from Six Teaching Hospitals in China

Chen

Wang

et al. 2015

Jpn J Infect Dis

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SUMMARY:To evaluate the in vitro antimicrobial activities of biapenem, arbekacin, and cefminox against different gram-negative bacterial isolates in China, a total of 100 non-duplicated Escherichia coli, 100 Acinetobacter baumannii, 100 Pseudomonas aeruginosa, and 99 Klebsiella pneumoniae isolates were collected from 6 teaching hospitals in China in 2012. The minimal inhibitory concentrations (MICs) of biapenem, arbekacin, cefminox and 13 other antibiotics were determined by the broth microdilution method. The carbapenems (biapenem, meropenem, and imipenem) exhibited high antimicrobial activity against E. coli (98z) and K. pneumoniae (95z), followed by colistin and amikacin. The MIC 50 and MIC 90 of biapenem against E. coli were 0.06 mg/L and 0.25 mg/L, respectively. For K. pneumoniae, the MIC 50 and MIC 90 of biapenem were 0.25 mg/L and 1.0 mg/L, respectively. The MIC 50 and MIC 90 of cefminox against E. coli were 1.0 mg/L and 4.0 mg/L, respectively. The resistance rates of A. baumannii to most of the antibiotics were more than 50z, except for colistin. Amikacin was the most active antibiotic against P. aeruginosa (97z), followed by colistin (93z). The MIC 50 and MIC 90 of arbekacin against P. aeruginosa were 2.0 mg/L and 8.0 mg/L, respectively. In conclusion, carbapenems, colistin, amikacin, and arbekacin exhibited high antimicrobial activities against gramnegative bacteria, except A. baumannii.

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Section: Discussionmentioning

confidence: 99%

In Vitro Analysis of Activities of 16 Antimicrobial Agents against Gram-Negative Bacteria from Six Teaching Hospitals in China

Chen

Wang

et al. 2015

Jpn J Infect Dis

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“…ST11 was found to be the dominant ST (16/17; 94.12 %). ST11 is the most common KPC-producing K. pneumoniae ST in China and some other regions, with only one single-locus variant found in ST258 (Giakkoupi et al, 2011;Li et al, 2014;Pereira et al, 2013). ST11 may have the potential to disseminate widely.…”

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confidence: 99%

Emergence and characterization of tigecycline resistance in multidrug-resistant Klebsiella pneumoniae isolates from blood samples of patients in intensive care units in northern China

Zhou²,

Zhai

et al. 2016

Journal of Medical Microbiology

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Serious infections in intensive care unit patients caused by multidrug-resistant (MDR) Klebsiella pneumoniae represent a major threat worldwide owing to increased mortality and limited treatment options. With the application of tigecycline for MDR pathogens, tigecycline-nonsusceptible K. pneumoniae isolates have recently emerged in China. To identify the susceptibility profile of MDR K. pneumoniae to tigecycline and evaluate the molecular characterization of tigecycline resistance, 214 MDR K. pneumoniae isolates were collected from blood samples of patients in intensive care units. MICs and clonal relatedness were determined by standard broth microdilution and multilocus sequence typing, respectively. Expression levels of efflux pumps and their global regulators were examined using real-time PCR. Mutations of local repressor were identified by PCR and sequencing. Our results show that the tigecycline resistance rate of 214 MDR K. pneumoniae isolates was 6.07 %. ST11 was the predominant clone type of tigecyclinenon-susceptible K. pneumoniae isolates. Expression of efflux pump AcrB and global regulator RamA correlated with tigecycline MICs (AcrB: x 2 =8.91, P=0.03; RamA: x 2 =13.91, P<0.01), and mean expression levels of AcrB for the MICs !4 mg l À1 were significantly higher than MICs 2 mg l À1 (t=2.48, P=0.029). In addition, one tigecycline-resistant isolate harboured a deletion mutation in the ramR gene. These data indicated a linear correlative trend for overexpression of the AcrB and the tigecycline MICs resulting from the upregulation of RamA. The emergence of molecular type ST11 of MDR K. pneumoniae isolates should be monitored to identify factors that contribute to tigecycline resistance in intensive care units.

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“…Because the predominant clone of CRKP is KPC-2-producing ST11 and the dominant clone of HvKP is ST23 in China [6,11,[19][20][21][22], these investigations imply the possibility for the direct transmission of a virulence plasmid from HvKP to KPC-2-producing CRKP. Danxia et al proved this possibility.…”

Section: Issn 0970-938x Wwwbiomedresinfomentioning

confidence: 99%

“…However, recent many reports have shown the emergence of antibiotic-resistant HvKP strains [6]. Especially, the emergence of Carbapenem-Resistant HvKP (CR-HvKP) was reported in China, where both carbapenem-resistant cKP (CRKP) and carbapenemsusceptible HvKP strains are prevalent [6,11]. A recent study performed by Danxia et al showed the emergence of CRHvKP ST11 strains caused by the transfer of a 170 kb pLVPKlike virulence plasmid into bla KPC-2 -harboring ST11 CRKP stains [12].…”

Section: Introductionmentioning

confidence: 99%

The threat of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-HvKP)

Lee¹,

Park²,

Lee³

et al. 2018

biomedicalresearch

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Klebsiella pneumoniae is one of clinically important opportunistic pathogens responsible for community-acquired and nosocomial infections in immunocompromised individuals. The increasing prevalence of carbapenem-resistant K. pneumoniae (CRKP) poses a serious threat to public health worldwide. With antibiotic resistance, hypervirulent K. pneumoniae (HvKP) responsible for serious disseminated infections in both healthy and immunocompromised individuals has also emerged. Recently, the emergence of carbapenem-resistant hypervirulent K. pneumoniae (CR-HvKP) strains has become a great challenge to public health. In this paper, we discuss the emergence mechanisms of CRHvKP through analyzing features of CR-HvKP strains isolated in China, where both CRKP and HvKP strains are prevalent. These analyses suggest that more extensive surveillance is required to accurately assess the potential threat of the plasmid-mediated convergence of carbapenem-resistance and hypervirulence.

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Molecular characteristics of carbapenemase-producing Enterobacteriaceae in China from 2008 to 2011: Predominance of KPC-2 enzyme

Cited by 57 publications

References 16 publications

In Vitro Analysis of Activities of 16 Antimicrobial Agents against Gram-Negative Bacteria from Six Teaching Hospitals in China

In Vitro Analysis of Activities of 16 Antimicrobial Agents against Gram-Negative Bacteria from Six Teaching Hospitals in China

Emergence and characterization of tigecycline resistance in multidrug-resistant Klebsiella pneumoniae isolates from blood samples of patients in intensive care units in northern China

The threat of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-HvKP)

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