Clinical imipenem non-susceptible Klebsiella pneumoniae isolates from China: Epidemiology, molecular characterization and in vitro activity of imipenem/relebactam

IF 3.2 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance Pub Date : 2025-05-15 DOI:10.1016/j.jgar.2025.05.011

Peiyao Jia , Pengcheng Li , Wei Yu , Xiaobing Chu , Hui Zhang , Jingjia Zhang , Wei Kang , Ge Zhang , Qian Zhang , Shiyu Chen , Yingchun Xu , Qiwen Yang

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引用次数: 0

Abstract

Objective

To describe the epidemiological and molecular characterization and in vitro activity of imipenem/relebactam against imipenem non-susceptible (IPMNS) Klebsiella pneumoniae isolates in China.

Methods

K. pneumoniae isolates were collected from 16 sites in 5 regions across China during 2019. Antimicrobial susceptibility testing was performed. For IPMNS K. pneumoniae isolates, whole genome sequencing was used to screen for drug-resistance and virulence genes.

Results

Of 1011 clinical K. pneumoniae isolates, 277 (27.3%) were IPMNS and were significantly more common in intensive care unit patients (47.5%) and hospital-acquired infections (28.9%). Production of carbapenemase was the dominant resistance mechanism, with 228 (89.8%) IPMNS isolates harbouring bla_KPC-2, 8 (3.1%) bla_NDM, 2 (0.8%) bla_OXA-232 and 1 (0.4%) bla_OXA-181. The dominant clone was sequence type (ST) 11 (78.7%) followed by ST15 (10.2%). Relebactam restored imipenem’s susceptibility in 96.5% isolates harbouring a bla_KPC-2 gene.

Conclusions

Harbouring the bla_KPC-2 gene was the dominant mechanism of IPMNS K. pneumoniae in China. Empirical imipenem/relebactam treatment could be considered when susceptibility or carbapenemase tests are not available.

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中国临床亚胺培南非敏感肺炎克雷伯菌分离株：流行病学、分子特征及亚胺培南/瑞巴坦体外活性

目的：了解亚胺培南/瑞巴坦对亚胺培南不敏感（IPMNS）肺炎克雷伯菌的流行病学、分子特征及体外活性。方法：2019年在全国5个地区16个地点采集肺炎克雷伯菌分离株。进行药敏试验。IPMNS肺炎克雷伯菌分离株采用全基因组测序筛选耐药和毒力基因。结果：1011株临床分离肺炎克雷伯菌中，IPMNS患者277株（27.3%），ICU患者多见（47.5%），医院获得性感染多见（28.9%）。产碳青霉烯酶是主要的耐药机制，228株（89.8%）IPMNS菌株携带blaKPC-2、8株（3.1%）blaNDM、2株（0.7%）blaOXA-232和1株（0.4%）blaOXA-181。优势克隆为st11型（78.7%），其次为ST15型（10.2%）。乐巴坦在96.3%携带blaKPC-2基因的分离株中恢复了亚胺培南的敏感性。结论：携带blaKPC-2基因是中国IPMNS肺炎克雷伯菌的主要机制。当没有易感性或碳青霉烯酶试验时，可考虑经验性亚胺培南/瑞巴坦治疗。

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

Journal of global antimicrobial resistance INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

8.70

自引率

2.20%

发文量

285

审稿时长

34 weeks

期刊介绍： The Journal of Global Antimicrobial Resistance (JGAR) is a quarterly online journal run by an international Editorial Board that focuses on the global spread of antibiotic-resistant microbes. JGAR is a dedicated journal for all professionals working in research, health care, the environment and animal infection control, aiming to track the resistance threat worldwide and provides a single voice devoted to antimicrobial resistance (AMR). Featuring peer-reviewed and up to date research articles, reviews, short notes and hot topics JGAR covers the key topics related to antibacterial, antiviral, antifungal and antiparasitic resistance.