scholarly journals High Prevalence of 16s rRNA Methylase Genes Among Carbapenem-Resistant Hypervirulent Klebsiella pneumoniae Isolates in a Chinese Tertiary Hospital

2020 ◽  
Author(s):  
Wenjian Liao ◽  
Liang De Wang ◽  
Dan Li ◽  
Fang-ling Du ◽  
Dan Long ◽  
...  
Keyword(s):  
16S Rrna ◽  
Klebsiella Pneumoniae ◽  
Tertiary Hospital ◽  
Carbapenem Resistant ◽  
High Prevalence ◽  
16S Rrna Methylase

scholarly journals High Prevalence of 16S rRNA methylase genes High Prevalence of 16S rRNA methylase genes Among Carbapenem-resistant Hypervirulent Klebsiella pneumoniae Isolates in China

2019 ◽  
Author(s):  
Wenjian Liao ◽  
Dan Li ◽  
Dan Dan Wei ◽  
Fang-lin Du ◽  
Dan Long ◽  
...  
Keyword(s):  
16S Rrna ◽  
Klebsiella Pneumoniae ◽  
Clinical Isolates ◽  
Aminoglycoside Resistance ◽  
Pfge Typing ◽  
Carbapenem Resistant ◽  
Carbapenemase Gene ◽  
High Prevalence ◽  
High Level ◽  
16S Rrna Methylase

Abstract Background : the existence of 16S rRNA methylase genes would increase treatment difficulty of patients infected with CR-hvKP strains, this study was aimed to testify the prevalence of the 16S rRNA methylase genes genes in the CR-hvKP strains in China.Methods : Thirty-nine carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) isolates collected from a Chinese hospital during the whole year of 2018 were evaluated to characterize the prevalence of 16S rRNA methylase genes. Results : In tatal 66.7% (26/39) of the CR-hvKP isolates were found to carry 16S rRNA methylase genes, and the most frequently detected gene was armA (11,42.3%), followed by rmtB (8,30.8%),and 7 CR-hvKP strains were found to carry both armA and rmtB (26.9%). All the clinical isolates were found to carry at least one carbapenemase gene,with KPC-2 (79.5%,31/39), NDM-1 (10.3%,4/39), and cocarrying KPC-2 and NDM-1 (10.3%,4/39). A total of 89.7% (35/39) isolates carried ESBL genes, including 61.5% (24/39) blaSHV-1 ,71.8% (28/39) blaTEM-1 and 89.7% (35/39) blaCTX-M-1 4. All except four isolates (89.7%,35/39) harbored PMQR genes,with qnrS (82.1%,32/39), aac(6’)-Ib-cr (79.5%,31/39), qnrB (2.6%,1/39).All the 16S rRNA methylase genes-positive CR-hvKP strains were firstly found to cocarry carbapenemase genes, ESBL genes and PMQR genes simultaneously. The most prevalent virulence genes were rmpA2 and entB (100%, 39/39),followed by silS (97.4%, 38/39), ybtS (94.9%, 37/39), iutA (92.3%, 36/39), kpn (92.3%, 36/39), rmpA (87.2%, 34/39), terW (84.6%, 33/39), aerobactin (23.1%, 9/39), repA (17.9%, 7/39), magA (10.3%, 4/39), kfuB C (10.3%, 4/39), w ca G (10.3%, 4/39), allS (10.3%, 4/39). Multilocus sequence typing (MLST) analysis assigned the 39 CR-hvKP isolates into 4 sequence types (STs), with ST11 encompassing 79.5% of the strains. Pulsed field gel electrophoresis (PFGE) typing showed that strains closely related by MLST clustered in major PFGE clusters, of which cluster A accounts for 31 ST11 isolates.The analysis of the transconjugants showed a high-level aminoglycoside resistance and a popular cotransfer of bla KPC-2 with the 16S rRNA methylase genes.Conclusions : 16S rRNA methylase genes are highly prevalent in CR-hvKP clinical isolates especially for ST11, it is therefore critical to continuously monitor the 16S rRNA methylase-producing CR-hvKP epidemiology and minimize potential risks from aminoglycoside -resistant CR-hvKP.

scholarly journals Molecular Epidemiology and Characterization of Carbapenem-Resistant Klebsiella pneumoniae Isolated from Urine at a Teaching Hospital in Taiwan

2021 ◽  
Vol 9 (2) ◽  
pp. 271
Author(s):  
Yuarn-Jang Lee ◽  
Chih-Hung Huang ◽  
Noor Andryan Ilsan ◽  
I-Hui Lee ◽  
Tzu-Wen Huang
Keyword(s):  
Klebsiella Pneumoniae ◽  
Teaching Hospital ◽  
Efflux Pump ◽  
Resistance Mechanisms ◽  
Pcr Analysis ◽  
Carbapenem Resistant ◽  
High Prevalence ◽  
Antimicrobial Susceptibility Tests ◽  
Susceptibility Tests ◽  
Tract Infections

Urinary tract infections (UTIs) are common in clinics and hospitals and are associated with a high economic burden. Enterobacterium Klebsiella pneumoniae is a prevalent agent causing UTIs. A high prevalence of carbapenem-resistant K. pneumoniae (CRKP) has emerged recently and is continuing to increase. Seventeen urinary CRKP isolates collected at a teaching hospital in Taiwan from December 2016 to September 2017 were analyzed to elucidate their drug resistance mechanisms. Two-thirds of the isolates were obtained from outpatients. Antimicrobial susceptibility tests demonstrated multidrug resistance in all the isolates. Multilocus sequence typing analysis showed high diversity among the isolates. PCR analysis demonstrated the presence of carbapenemases in three isolates. All isolates carried at least one other extended-spectrum β-lactamase, including TEM, DHA, and CTX-M. Fifteen isolates contained mutations in one of the outer membrane porins that were assessed. The expression levels of the acrB and/or oqxB efflux pump genes, as determined by qRT-PCR, were upregulated in 11 isolates. Six isolates might have utilized other efflux pumps or antimicrobial resistance mechanisms. These analyses demonstrated a highly diverse population and the presence of complex resistance mechanisms in urinary isolates of K. pneumoniae.

scholarly journals Carbapenem-resistant and carbapenem-susceptible isogenic isolates of Klebsiella pneumoniae ST101 causing infection in a tertiary hospital

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Meritxell Cubero ◽  
Guillermo Cuervo ◽  
M. Ángeles Dominguez ◽  
Fe Tubau ◽  
Sara Martí ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Tertiary Hospital ◽  
Carbapenem Resistant

First description of NDM-1-, KPC-2-, VIM-2- and IMP-4-producing Klebsiella pneumoniae strains in a single Chinese teaching hospital

2014 ◽  
Vol 143 (2) ◽  
pp. 376-384 ◽  
Author(s):  
Y. LIU ◽  
L.-G. WAN ◽  
Q. DENG ◽  
X.-W. CAO ◽  
Y. YU ◽  
...  
Keyword(s):  
16S Rrna ◽  
Klebsiella Pneumoniae ◽  
Teaching Hospital ◽  
Multidrug Resistant ◽  
The Other ◽  
Quinolone Resistance ◽  
Resistance Determinants ◽  
Carbapenem Resistant ◽  
Extended Spectrum ◽  
Chinese Teaching

SUMMARYA 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. blaKPC-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, blaNDM-1 was associated with a ~70 kb IncA/C plasmid (ST263). However, non-typable plasmids of ~40 kb containing blaVIM-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.

scholarly journals Prediction of Prognosis in Adult Patients With Carbapenem-Resistant Klebsiella pneumoniae Infection

2022 ◽  
Vol 11 ◽  
Author(s):  
Jihui Chen ◽  
Yu Yang ◽  
Huimin Yao ◽  
Shuhong Bu ◽  
Lixia Li ◽  
...  
Keyword(s):  
High Risk ◽  
Klebsiella Pneumoniae ◽  
Treatment Effectiveness ◽  
Risk Group ◽  
Clinical Information ◽  
Tertiary Hospital ◽  
High Risk Group ◽  
Adult Patients ◽  
Carbapenem Resistant ◽  
Prediction Of Prognosis

ObjectiveCarbapenem-resistant Klebsiella pneumoniae (CRKP) infections are associated with poor patient outcomes. We aimed to analyze the clinical information of adult patients with CRKP infection in order to establish a nomogram for mortality risk as well as to determine the treatment effectiveness of different antimicrobial regimens.MethodsAdult patients diagnosed with CRKP infection in a tertiary hospital in Shanghai between September 2019 and March 2021 were included. The clinical characteristics and clinical outcomes of these patients were analyzed.ResultsA total of 199 cases of CRKP infection were examined. Five factors, namely age ≥65 years, respiratory failure, Sequential Organ Failure Assessment score, serum procalcitonin ≥5 ng/mL, and appropriate treatments in 3 days, were found to be associated with 30-day mortality. Upon incorporating these factors, the nomogram achieved good concordance indexes of 0.85 (95% confidence interval [CI]: 0.80–0.90) and well-fitted calibration curves. Receiver-operating characteristic curves for 7-, 15-, and 30-day survival had areas under the curve of 0.90, 0.87, and 0.88, respectively. Three-drug combination therapy was observed to be associated with lower mortality in the high-risk group (adjusted hazard ratio = 0.24, 95% CI: 0.06–0.99) but not in the low-risk group. Ceftazidime–avibactam, fosfomycin, and amikacin were effective against infections caused by CRKP. Tigecycline improved the treatment efficiency in 7 days, but a trend toward increased mortality was seen (HR, 1.69; 95% CI: 0.98–2.94; P = 0.061).ConclusionThe antimicrobial regimen efficacy data and the predictive nomogram established in this study can help clinicians in identifying high-risk adult patients with CRKP infection, improving the therapeutic effect, and reducing mortality.

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