Microbiological Characteristics of Carbapenem-Resistant Enterobacteriaceae Clinical Isolates Collected from County Hospitals
Authors Xie S, Fu S, Li M, Guo Z, Zhu X, Ren J, Hu F
Received 3 February 2020
Accepted for publication 31 March 2020
Published 22 April 2020 Volume 2020:13 Pages 1163—1169
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Sahil Khanna
Shujin Xie,1,2,* Shiming Fu,3,* Mengwei Li,4 Zhusheng Guo,2 Xuehai Zhu,2 Jianmin Ren,5 Fupin Hu1,6
1Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China; 2Tungwah Hospital of Sun Yat-Sen University, Dongguan, People’s Republic of China; 3Department of Clinical Laboratory, The Traditional Chinese Medical Hospital of Suichang, Zhejiang, People’s Republic of China; 4Clinical Microbiology Laboratory, Department of Liuzhou Worker Hospital, Guangxi, People’s Republic of China; 5Institute of Antibiotics, The Central Hospital of Lishui City, Zhejiang, People’s Republic of China; 6Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Fupin Hu
Institute of Antibiotics, Huashan Hospital, Fudan University, 12 M. Wulumuqi Road, Shanghai 200040, People’s Republic of China
Objective: To investigate the molecular characteristics of carbapenem-resistant Enterobacteriaceae (CRE) from county hospitals in China.
Materials and Methods: Forty-three sequential non-duplicate CRE strains (including 33 Klebsiella pneumoniae isolates, 4 Enterobacter cloacae isolates, 3 Escherichia coli isolates, 1 Serratia marcescens, 1 Morganella morganii and 1 Citrobacter freundii) were collected from 4 county hospitals and 2 municipal hospitals. Antimicrobial susceptibility testing was conducted by broth microdilution method, using 3-aminophenylboronic acid and EDTA and the modified carbapenem inactivation method (mCIM) to screen phenotype of carbapenemase. β-Lactamases were characterized by polymerase chain reaction (PCR) and DNA sequencing. The transferability of blaNDM-5 was investigated by transformation experiment. Clonal relatedness was evaluated by pulsed-field gel electrophoresis and multilocus sequence typing .
Results: The results of antimicrobial susceptibility testing indicated that 43 CRE strains were resistant to most of the antimicrobial agents, except tigecycline and colistin. Overall, 93%, 93%, and 97.7% of these strains were resistant to imipenem, meropenem, and ertapenem, respectively. PCR and DNA sequencing indicated that 67.4% (29/43) were blaKPC-2 positive isolates, in which 3.4% (1/29) was coproduced with blaNDM-1. In addition, 7.0% (3/43), 4.7% (2/43), 4.7% (2/43), 2.3% (1/43), 2.3% (1/43) were blaNDM-1, blaNDM-16, blaNDM-4, blaNDM-5, blaIMP-4 positive isolates, respectively. The 29 blaKPC-2-positive isolates belonged to 12 different PFGE type and designated as ST11 (n=20) and ST15, ST39, ST116, ST667, ST2245, ST2338. The plasmid bearing blaNDM-5 could be transferred into recipient E. coli J53 through transformation.
Conclusion: Our study indicated the dissemination of CRE between the tertiary hospitals and secondary hospitals.
Keywords: Enterobacteriaceae, blaKPC-2, blaNDM-1
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]