Lijun Yin, Lu Lu, Leiyan He, Laishuan Wang, Guoping Lu, Yun Cao, Xiaowen Zhai, Chuanqing Wang
{"title":"2017-2021年,中国上海一家儿童医院新生儿患者耐碳青霉烯类克雷伯菌肺炎感染的显性序列型从ST278-NDM-1转变为ST11-KPC-2。","authors":"Lijun Yin, Lu Lu, Leiyan He, Laishuan Wang, Guoping Lu, Yun Cao, Xiaowen Zhai, Chuanqing Wang","doi":"10.1007/s10123-023-00436-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the clinical characteristics and molecular epidemiology of CRKP infection in neonatal patients in a children's hospital in China from 2017 to 2021.</p><p><strong>Methods: </strong>Species identification and antibiotic susceptibilities were tested with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and VITEK 2 systems. The clinical data were collected from medical records. Carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates were investigated by antimicrobial susceptibility testing, carbapenemase genes and multilocus sequence typing.</p><p><strong>Results: </strong>Six kinds of resistant genes and 23 STs were detected. Bla<sub>NDM-1</sub> (n=83, 55.3%) was the predominant carbapenemase gene, followed by bla<sub>KPC-2</sub> (n=45, 30.0%), bla<sub>NDM-5</sub> (n=7, 4.7%), bla<sub>IMP-38</sub> (n=6, 4.0%). Bla<sub>NDM-1</sub> was predominant in 2017 and 2018, whereas bla<sub>KPC-2</sub> increased in 2019 and became the predominant gene from 2020 to 2021. ST11 accounted for most infections (n=35, 23.3%), followed by ST278 (n=23, 15.3%), ST17 (n=17, 11. 3%) and ST2735 (n=16, 10.7%). ST278 and ST17 were predominant in 2017 and 2018, whereas ST11 increased in 2019 and became the predominant sequence type from 2020 to 2021. Compared with bla<sub>NDM-1</sub>, the CRKP strains producing bla<sub>KPC-2</sub> were characterized by high resistance to gentamicin, amikacin and levofloxacin and the change trend of drug resistance rate before and after COVID-19 was consistent with that of bla<sub>NDM-1</sub> and bla<sub>KPC-2</sub>.</p><p><strong>Conclusions: </strong>The main sequence type of CRKP infection changed dynamically from ST278-NDM-1 to ST11-KPC-2 during the years 2017-2021 in the newborns. Antibiotic exposure and the prevalence of COVID-19 since 2020 may have led to changes in hospital population and lead to the changes.</p>","PeriodicalId":14318,"journal":{"name":"International Microbiology","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Shift in the dominant sequence type of carbapenem-resistant Klebsiella pneumonia infection from ST278-NDM-1 to ST11-KPC-2 in neonatal patients in a children's hospital in Shanghai, China, 2017-2021.\",\"authors\":\"Lijun Yin, Lu Lu, Leiyan He, Laishuan Wang, Guoping Lu, Yun Cao, Xiaowen Zhai, Chuanqing Wang\",\"doi\":\"10.1007/s10123-023-00436-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To investigate the clinical characteristics and molecular epidemiology of CRKP infection in neonatal patients in a children's hospital in China from 2017 to 2021.</p><p><strong>Methods: </strong>Species identification and antibiotic susceptibilities were tested with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and VITEK 2 systems. The clinical data were collected from medical records. Carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates were investigated by antimicrobial susceptibility testing, carbapenemase genes and multilocus sequence typing.</p><p><strong>Results: </strong>Six kinds of resistant genes and 23 STs were detected. Bla<sub>NDM-1</sub> (n=83, 55.3%) was the predominant carbapenemase gene, followed by bla<sub>KPC-2</sub> (n=45, 30.0%), bla<sub>NDM-5</sub> (n=7, 4.7%), bla<sub>IMP-38</sub> (n=6, 4.0%). Bla<sub>NDM-1</sub> was predominant in 2017 and 2018, whereas bla<sub>KPC-2</sub> increased in 2019 and became the predominant gene from 2020 to 2021. ST11 accounted for most infections (n=35, 23.3%), followed by ST278 (n=23, 15.3%), ST17 (n=17, 11. 3%) and ST2735 (n=16, 10.7%). ST278 and ST17 were predominant in 2017 and 2018, whereas ST11 increased in 2019 and became the predominant sequence type from 2020 to 2021. Compared with bla<sub>NDM-1</sub>, the CRKP strains producing bla<sub>KPC-2</sub> were characterized by high resistance to gentamicin, amikacin and levofloxacin and the change trend of drug resistance rate before and after COVID-19 was consistent with that of bla<sub>NDM-1</sub> and bla<sub>KPC-2</sub>.</p><p><strong>Conclusions: </strong>The main sequence type of CRKP infection changed dynamically from ST278-NDM-1 to ST11-KPC-2 during the years 2017-2021 in the newborns. Antibiotic exposure and the prevalence of COVID-19 since 2020 may have led to changes in hospital population and lead to the changes.</p>\",\"PeriodicalId\":14318,\"journal\":{\"name\":\"International Microbiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Microbiology\",\"FirstCategoryId\":\"99\",\"ListUrlMain\":\"https://doi.org/10.1007/s10123-023-00436-z\",\"RegionNum\":4,\"RegionCategory\":\"生物学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/10/19 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"BIOTECHNOLOGY & APPLIED MICROBIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Microbiology","FirstCategoryId":"99","ListUrlMain":"https://doi.org/10.1007/s10123-023-00436-z","RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/19 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"BIOTECHNOLOGY & APPLIED MICROBIOLOGY","Score":null,"Total":0}
Shift in the dominant sequence type of carbapenem-resistant Klebsiella pneumonia infection from ST278-NDM-1 to ST11-KPC-2 in neonatal patients in a children's hospital in Shanghai, China, 2017-2021.
Objectives: To investigate the clinical characteristics and molecular epidemiology of CRKP infection in neonatal patients in a children's hospital in China from 2017 to 2021.
Methods: Species identification and antibiotic susceptibilities were tested with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and VITEK 2 systems. The clinical data were collected from medical records. Carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates were investigated by antimicrobial susceptibility testing, carbapenemase genes and multilocus sequence typing.
Results: Six kinds of resistant genes and 23 STs were detected. BlaNDM-1 (n=83, 55.3%) was the predominant carbapenemase gene, followed by blaKPC-2 (n=45, 30.0%), blaNDM-5 (n=7, 4.7%), blaIMP-38 (n=6, 4.0%). BlaNDM-1 was predominant in 2017 and 2018, whereas blaKPC-2 increased in 2019 and became the predominant gene from 2020 to 2021. ST11 accounted for most infections (n=35, 23.3%), followed by ST278 (n=23, 15.3%), ST17 (n=17, 11. 3%) and ST2735 (n=16, 10.7%). ST278 and ST17 were predominant in 2017 and 2018, whereas ST11 increased in 2019 and became the predominant sequence type from 2020 to 2021. Compared with blaNDM-1, the CRKP strains producing blaKPC-2 were characterized by high resistance to gentamicin, amikacin and levofloxacin and the change trend of drug resistance rate before and after COVID-19 was consistent with that of blaNDM-1 and blaKPC-2.
Conclusions: The main sequence type of CRKP infection changed dynamically from ST278-NDM-1 to ST11-KPC-2 during the years 2017-2021 in the newborns. Antibiotic exposure and the prevalence of COVID-19 since 2020 may have led to changes in hospital population and lead to the changes.
期刊介绍:
International Microbiology publishes information on basic and applied microbiology for a worldwide readership. The journal publishes articles and short reviews based on original research, articles about microbiologists and their work and questions related to the history and sociology of this science. Also offered are perspectives, opinion, book reviews and editorials.
A distinguishing feature of International Microbiology is its broadening of the term microbiology to include eukaryotic microorganisms.