Epidemiological and molecular characteristics of carbapenem-resistant Klebsiella pneumoniae from pediatric patients in Henan, China.

IF 4.6 2区医学 Q1 MICROBIOLOGY

Annals of Clinical Microbiology and Antimicrobials Pub Date : 2024-11-07 DOI:10.1186/s12941-024-00757-5

Jiayue Ma, Kaijie Gao, Mingchao Li, Juanjuan Zhou, Xiaorui Song, Yaodong Zhang, Zhidan Yu, Zengyuan Yu, Weyland Cheng, Wancun Zhang, Adong Shen, Junmei Yang, Huiqing Sun, Lifeng Li

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引用次数: 0

Abstract

Purpose: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an emerging global threat, whereas its epidemiological characteristics in children are rarely reported. This study aims to analyze clinical and epidemiological characteristics of CRKP from children in Henan, China.

Methods: CRKP strains were isolated from pediatric patients, and the antimicrobial susceptibility of CRKP was determined using broth microdilution methods. The epidemiological characteristics of CRKP, including specimen sources, clinical data, carbapenemase types, virulence factors, MLST and PBRT typing were analyzed.

Results: In total, 108 CRKP isolates were isolated from specimens including sputum, blood and urine, mainly from preterm pediatric department and internal medical intensive care unit (ICU). Newborns and staying in the ICU were risk factors for crude mortality. 107 isolates exhibited a multi-drug resistant (MDR) phenotype, and one isolate was extensively drug-resistant (XDR). Bacterial susceptibility to colistin, tigecycline and trimethoprim/sulfamethoxazole was 98.10%, 78.50% and 91.43%, respectively. Carbapenemase bla_KPC (86.11%) was predominant, followed by bla_NDM (5.56%) and bla_IMP (2.78%). Two strains co-harbored bla_KPC-bla_NDM, one had bla_KPC-bla_IMP, whereas three isolates did not carry any of the analyzed carbapenemase genes. All strains possessed fimH, and 98% of the isolates possessed mrkD. Hypervirulent factors rmpA2 and iucA showed high positive rates (71.30% and 49.07%), with 48.15% of strains containing both genes. MLST analysis identified nine distinct sequence types (STs), with ST11 (82.41%) being the most common, followed by ST2154 (4.63%) and ST307 (3.70%). PBRT analysis revealed IncFII (85.19%) as the most prevalent plasmid.

Conclusion: In summary, this study reported the epidemiological features of CRKP in pediatric patients in Henan, China, highlighting the high prevalence of multi-drug-resistant and hypervirulent strains, and underscoring the significance of continuous surveillance.

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中国河南儿科耐碳青霉烯类肺炎克雷伯菌的流行病学和分子特征。

目的：耐碳青霉烯类肺炎克雷伯氏菌（CRKP）是一种新出现的全球性威胁，但其在儿童中的流行病学特征却鲜有报道。本研究旨在分析中国河南儿童中 CRKP 的临床和流行病学特征：方法：从儿童患者中分离CRKP菌株，采用肉汤微量稀释法测定CRKP的抗菌药敏感性。分析了CRKP的流行病学特征，包括标本来源、临床数据、碳青霉烯酶类型、毒力因素、MLST和PBRT分型：从痰液、血液和尿液等标本中共分离出108株CRKP，主要来自早产儿科和内科重症监护室（ICU）。新生儿和住在重症监护室是导致粗死亡率的风险因素。107株分离菌表现出多重耐药（MDR）表型，1株分离菌具有广泛耐药（XDR）。细菌对可乐定、替加环素和三甲双氨/磺胺甲噁唑的敏感性分别为98.10%、78.50%和91.43%。碳青霉烯酶 blaKPC（86.11%）占主导地位，其次是 blaNDM（5.56%）和 blaIMP（2.78%）。两株菌株共同携带 blaKPC-blaNDM，一株携带 blaKPC-blaIMP，而三株分离菌株不携带任何分析出的碳青霉烯酶基因。所有菌株都携带 fimH，98% 的分离物携带 mrkD。高毒因子 rmpA2 和 iucA 的阳性率很高（分别为 71.30% 和 49.07%），48.15% 的菌株同时含有这两个基因。MLST 分析确定了九种不同的序列类型（ST），其中 ST11（82.41%）最为常见，其次是 ST2154（4.63%）和 ST307（3.70%）。PBRT分析显示，IncFII（85.19%）是最常见的质粒：总之，本研究报告了中国河南儿科患者中 CRKP 的流行病学特征，强调了多重耐药菌株和高病毒菌株的高流行率，并强调了持续监测的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Clinical Microbiology and Antimicrobials MICROBIOLOGY-

CiteScore

8.60

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Annals of Clinical Microbiology and Antimicrobials considers good quality, novel and international research of more than regional relevance. Research must include epidemiological and/or clinical information about isolates, and the journal covers the clinical microbiology of bacteria, viruses and fungi, as well as antimicrobial treatment of infectious diseases. Annals of Clinical Microbiology and Antimicrobials is an open access, peer-reviewed journal focusing on information concerning clinical microbiology, infectious diseases and antimicrobials. The management of infectious disease is dependent on correct diagnosis and appropriate antimicrobial treatment, and with this in mind, the journal aims to improve the communication between laboratory and clinical science in the field of clinical microbiology and antimicrobial treatment. Furthermore, the journal has no restrictions on space or access; this ensures that the journal can reach the widest possible audience.