ST11 Carbapenem-Resistant <i>Klebsiella pneumoniae</i> Clone Harboring <i>bla</i>_NDM Replaced a <i>bla</i>_KPC Clone in a Tertiary Hospital in China

• Main Authors: Qiaoyan Duan (Author), Qi Wang (Author), Shijun Sun (Author), Qiaozhen Cui (Author), Qi Ding (Author), Ruobing Wang (Author), Hui Wang (Author)
• Format: Book
• Published: MDPI AG, 2022-10-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

The nosocomial spread of carbapenem-resistant Enterobacterales (CRE) is extremely common, resulting in severe burdens on healthcare systems. In particular, the high-risk <i>Klebsiella pneumoniae</i> ST11 strain has a wide endemic area in China. The current study describes the results of continuous monitoring of CRE genotypes and phenotypes in a tertiary hospital in North China from 2012 to 2020. A total of 160 isolates were collected, including 109 <i>Klebsiella. pneumoniae</i> (68.13%), 29 <i>Escherichia coli</i> (26.60%), 12 <i>Enterobacter cloacae</i> (7.50%), and 10 other strains (6.25%). A total of 149 carbapenemase genes were detected, of which <i>bla</i>_KPC_-2 (51.0%) was the most common, followed by <i>bla</i>_NDM_-1 (22.82%), and <i>bla</i>_NDM_-5 (23.49%). Based on multi-locus sequence typing, the ST11 strain (66.1%) dominates <i>K. pneumoniae</i>, followed by ST15 (13.8%). Interestingly, the proportion of <i>bla</i>_NDM (22.2%, 16/72) in ST11 <i>K. pneumoniae</i> was significantly increased in 2018-2019. Hence, whole-genome sequencing was performed on ST11 <i>K. pneumoniae.</i> Growth curves and in vitro competition experiments showed that <i>K. pneumoniae</i> carrying <i>bla</i>_NDM exhibited a stronger growth rate (<i>p</i> < 0.001) and competition index (<i>p</i> < 0.001) than <i>K. pneumoniae</i> carrying <i>bla</i>_KPC. Moreover, <i>K. pneumoniae</i> carrying <i>bla</i>_NDM had a stronger biofilm-forming ability than <i>K. pneumoniae</i> carrying <i>bla</i>_KPC (<i>t</i> = 6.578; <i>p</i> < 0.001). <i>K. pneumoniae</i> carrying <i>bla</i>_KPC exhibited increased defense against bactericidal activity than <i>K. pneumoniae</i> carrying <i>bla</i>_NDM. Thus, ST11 <i>K. pneumoniae</i> carrying <i>bla</i>_NDM has strong adaptability and can locally replace <i>K. pneumoniae</i> carrying <i>bla</i>_KPC to become an epidemic strain. Based on these findings, infection control and preventive measures should focus on the high-risk ST11-<i>K. pneumoniae</i> strain.

Item Description

10.3390/antibiotics11101373
2079-6382