X W Ning, Y X Tang, S Y Wang, X M Wang, H B Zhu, X B Xie, Q Y Liu
{"title":"[湖南省某医院耐碳青霉烯类肺炎克雷伯菌分子流行病学特征分析]。","authors":"X W Ning, Y X Tang, S Y Wang, X M Wang, H B Zhu, X B Xie, Q Y Liu","doi":"10.3760/cma.j.cn112150-20240301-00172","DOIUrl":null,"url":null,"abstract":"<p><p>To examine the molecular epidemiology of carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) and investigate the horizontal transmission of <i>bla</i><sub>KPC</sub> and <i>bla</i><sub>NDM</sub> genes for the prevention and treatment of CRKP. A total of 49 clinically isolated CRKP strains were retrospectively analyzed from January to December 2022 at The First Hospital of Hunan University of Chinese Medicine. Phenotypic screening was performed using modified carbapenem inactivation assay (mCIM) and EDTA-carbapenem inactivation assay (eCIM). Polymerase chain reaction (PCR) was utilized to identify carbapenem resistance genes, β-lactamase resistance genes, and virulence genes, while multi-locus sequence analysis (MLST) was employed to assess the homology of CRKP strains. Conjugation experiments were conducted to infer the horizontal transmission mechanism of <i>bla</i><sub>KPC</sub> and <i>bla</i><sub>NDM</sub> genes. The results showed that the study included 49 CRKP strains, with 44 carrying <i>bla</i><sub>KPC</sub> and 8 carrying <i>bla</i><sub>NDM,</sub> Three strains were identified as <i>bla</i><sub>KPC</sub>+<i>bla</i><sub>NDM</sub>-CRKP. In this study, 28 out of 49 CRKP strains (57.2%) were found to carry virulence genes. Additionally, one CRKP strain tested positive in the string test and was found to carry both <i>Aerobactin</i> and <i>rmpA</i> virulence genes. MLST results revealed a total of 5 ST types, with ST11 being predominant (41/49, 83.7%). Successful conjugation was observed in all 3 <i>bla</i><sub>KPC</sub>-CRKP strains, while only 1 out of 3 <i>bla</i><sub>NDM</sub>-CRKP strains showed successful conjugation. The transconjugant exhibited significantly reduced susceptibility to imipenem and cephalosporin antibiotics. In conclusion, the resistance mechanism of CRKP in this study is primarily attributed to the production of KPC enzymes, along with the presence of multiple β-lactamase resistance genes. Additionally, there is a local prevalence of hv-CRKP and <i>bla</i><sub>KPC</sub>+<i>bla</i><sub>NDM</sub>-CRKP. <i>bla</i><sub>KPC</sub> and <i>bla</i><sub>NDM</sub> can be horizontally transmitted through plasmids, with varying efficiency among different strains.</p>","PeriodicalId":24033,"journal":{"name":"中华预防医学杂志","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Analysis of the molecular epidemiological characteristics of carbapenem-resistant <i>Klebsiella pneumoniae</i> in a hospital in Hunan Province].\",\"authors\":\"X W Ning, Y X Tang, S Y Wang, X M Wang, H B Zhu, X B Xie, Q Y Liu\",\"doi\":\"10.3760/cma.j.cn112150-20240301-00172\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>To examine the molecular epidemiology of carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) and investigate the horizontal transmission of <i>bla</i><sub>KPC</sub> and <i>bla</i><sub>NDM</sub> genes for the prevention and treatment of CRKP. A total of 49 clinically isolated CRKP strains were retrospectively analyzed from January to December 2022 at The First Hospital of Hunan University of Chinese Medicine. Phenotypic screening was performed using modified carbapenem inactivation assay (mCIM) and EDTA-carbapenem inactivation assay (eCIM). Polymerase chain reaction (PCR) was utilized to identify carbapenem resistance genes, β-lactamase resistance genes, and virulence genes, while multi-locus sequence analysis (MLST) was employed to assess the homology of CRKP strains. Conjugation experiments were conducted to infer the horizontal transmission mechanism of <i>bla</i><sub>KPC</sub> and <i>bla</i><sub>NDM</sub> genes. The results showed that the study included 49 CRKP strains, with 44 carrying <i>bla</i><sub>KPC</sub> and 8 carrying <i>bla</i><sub>NDM,</sub> Three strains were identified as <i>bla</i><sub>KPC</sub>+<i>bla</i><sub>NDM</sub>-CRKP. In this study, 28 out of 49 CRKP strains (57.2%) were found to carry virulence genes. Additionally, one CRKP strain tested positive in the string test and was found to carry both <i>Aerobactin</i> and <i>rmpA</i> virulence genes. MLST results revealed a total of 5 ST types, with ST11 being predominant (41/49, 83.7%). Successful conjugation was observed in all 3 <i>bla</i><sub>KPC</sub>-CRKP strains, while only 1 out of 3 <i>bla</i><sub>NDM</sub>-CRKP strains showed successful conjugation. The transconjugant exhibited significantly reduced susceptibility to imipenem and cephalosporin antibiotics. In conclusion, the resistance mechanism of CRKP in this study is primarily attributed to the production of KPC enzymes, along with the presence of multiple β-lactamase resistance genes. Additionally, there is a local prevalence of hv-CRKP and <i>bla</i><sub>KPC</sub>+<i>bla</i><sub>NDM</sub>-CRKP. <i>bla</i><sub>KPC</sub> and <i>bla</i><sub>NDM</sub> can be horizontally transmitted through plasmids, with varying efficiency among different strains.</p>\",\"PeriodicalId\":24033,\"journal\":{\"name\":\"中华预防医学杂志\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华预防医学杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/cma.j.cn112150-20240301-00172\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华预防医学杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/cma.j.cn112150-20240301-00172","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
[Analysis of the molecular epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae in a hospital in Hunan Province].
To examine the molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae (CRKP) and investigate the horizontal transmission of blaKPC and blaNDM genes for the prevention and treatment of CRKP. A total of 49 clinically isolated CRKP strains were retrospectively analyzed from January to December 2022 at The First Hospital of Hunan University of Chinese Medicine. Phenotypic screening was performed using modified carbapenem inactivation assay (mCIM) and EDTA-carbapenem inactivation assay (eCIM). Polymerase chain reaction (PCR) was utilized to identify carbapenem resistance genes, β-lactamase resistance genes, and virulence genes, while multi-locus sequence analysis (MLST) was employed to assess the homology of CRKP strains. Conjugation experiments were conducted to infer the horizontal transmission mechanism of blaKPC and blaNDM genes. The results showed that the study included 49 CRKP strains, with 44 carrying blaKPC and 8 carrying blaNDM, Three strains were identified as blaKPC+blaNDM-CRKP. In this study, 28 out of 49 CRKP strains (57.2%) were found to carry virulence genes. Additionally, one CRKP strain tested positive in the string test and was found to carry both Aerobactin and rmpA virulence genes. MLST results revealed a total of 5 ST types, with ST11 being predominant (41/49, 83.7%). Successful conjugation was observed in all 3 blaKPC-CRKP strains, while only 1 out of 3 blaNDM-CRKP strains showed successful conjugation. The transconjugant exhibited significantly reduced susceptibility to imipenem and cephalosporin antibiotics. In conclusion, the resistance mechanism of CRKP in this study is primarily attributed to the production of KPC enzymes, along with the presence of multiple β-lactamase resistance genes. Additionally, there is a local prevalence of hv-CRKP and blaKPC+blaNDM-CRKP. blaKPC and blaNDM can be horizontally transmitted through plasmids, with varying efficiency among different strains.
期刊介绍：
Chinese Journal of Preventive Medicine (CJPM), the successor to Chinese Health Journal , was initiated on October 1, 1953. In 1960, it was amalgamated with the Chinese Medical Journal and the Journal of Medical History and Health Care , and thereafter, was renamed as People’s Care . On November 25, 1978, the publication was denominated as Chinese Journal of Preventive Medicine . The contents of CJPM deal with a wide range of disciplines and technologies including epidemiology, environmental health, nutrition and food hygiene, occupational health, hygiene for children and adolescents, radiological health, toxicology, biostatistics, social medicine, pathogenic and epidemiological research in malignant tumor, surveillance and immunization.
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