An outbreak of infections caused by extensively drug-resistant Klebsiella pneumoniae strains during a short period of time in a Chinese teaching hospital: Epidemiology study and molecular characteristics

Diagnostic Microbiology and Infectious Disease

Volumn 82, Issue 3, 2015, Pages 240-244

  Zhou, Tieli ^a,b   Zhang, Yapei ^b   Li, Meimei ^b   Yu, Xiao ^c   Sun, Yao ^b   Xu, Jiru ^a  

^a XI'AN JIAOTONG UNIVERSITY   (China)

^b THE FIRST AFFILIATED HOSPITAL OF WENZHOU MEDICAL UNIVERSITY   (China)

^c WENZHOU MEDICAL UNIVERSITY   (China)

Author keywords

16S rRNA methylase; Klebsiella pneumoniae; KPC 2; Southern hybridization; ST11; XDR

Indexed keywords

AMIKACIN; CEFOTAXIME; CEFTAZIDIME; CEFTRIAXONE; CHLORAMPHENICOL; CIPROFLOXACIN; COLISTIN; COTRIMOXAZOLE; ERTAPENEM; GENTAMICIN; IMIPENEM; LEVOFLOXACIN; MEROPENEM; OUTER MEMBRANE PROTEIN; PIPERACILLIN PLUS TAZOBACTAM; SULTAMICILLIN; TIGECYCLINE; TOBRAMYCIN; BETA LACTAMASE; BETA-LACTAMASE KPC-2; CARRIER PROTEIN;

AAC(6') IB CR GENE; ADULT; AGED; ANTIBIOTIC SENSITIVITY; ARMA GENE; ARTICLE; BACTERIAL GENE; BACTERIAL STRAIN; BACTERIUM CONJUGATION; BLACTM M 1 GENE; BLACTX M 65 GENE; BLAKPC 2 GENE; BLASHV 11 GENE; BLATEM 1 GENE; CLINICAL ARTICLE; CONTROLLED STUDY; EPIDEMIC; EXTENSIVELY DRUG RESISTANT KLEBSIELLA PNEUMONIAE; HORIZONTAL GENE TRANSFER; HUMAN; KLEBSIELLA PNEUMONIAE; KLEBSIELLA PNEUMONIAE INFECTION; LONG TERM CARE; MIDDLE AGED; MINIMUM INHIBITORY CONCENTRATION; MORTALITY; NONHUMAN; OQXA GENE; OQXB GENE; POLYACRYLAMIDE GEL ELECTROPHORESIS; PRIORITY JOURNAL; RMTB GENE; SOUTHERN BLOTTING; TEACHING HOSPITAL; ANALYSIS; CHINA; CLASSIFICATION; CLUSTER ANALYSIS; CROSS INFECTION; DNA SEQUENCE; DRUG EFFECTS; FEMALE; GENETICS; ISOLATION AND PURIFICATION; KLEBSIELLA INFECTIONS; MALE; MICROBIOLOGY; MOLECULAR TYPING; MULTIDRUG RESISTANCE; PLASMID; RETROSPECTIVE STUDY; SECRETION (PROCESS); SURVIVAL;

AGED; BETA-LACTAMASES; CHINA; CLUSTER ANALYSIS; CONJUGATION, GENETIC; CROSS INFECTION; DISEASE OUTBREAKS; DRUG RESISTANCE, MULTIPLE, BACTERIAL; ELECTROPHORESIS, POLYACRYLAMIDE GEL; FEMALE; GENE TRANSFER, HORIZONTAL; GENES, BACTERIAL; HOSPITALS, TEACHING; HUMANS; KLEBSIELLA INFECTIONS; KLEBSIELLA PNEUMONIAE; MALE; MEMBRANE TRANSPORT PROTEINS; MIDDLE AGED; MOLECULAR TYPING; PLASMIDS; RETROSPECTIVE STUDIES; SEQUENCE ANALYSIS, DNA; SURVIVAL ANALYSIS;

EID: 84941874986     PISSN: 07328893     EISSN: 18790070     Source Type: Journal    
DOI: 10.1016/j.diagmicrobio.2015.03.017     Document Type: Article

References (26)

1. Barriere S.L. Bacterial resistance to beta-lactams, and its prevention with combination antimicrobial therapy. Pharmacotherapy 1992, 12:397-402.
2. Clinical and Laboratory Standards Institute (CLSI) Performance standards for antimicrobial susceptibility testing, 24th informational supplement (M100-S24) 2014, CLSI, Wayne, PA.
3. Domenech-Sanchez A., Martinez-Martinez L., Hernandez-Alles S., del Carmen Conejo M., Pascual A., Tomas J.M., et al. Role of Klebsiella pneumoniae OmpK35 porin in antimicrobial resistance. Antimicrob Agents Chemother 2003, 47:3332-3335.
4. Endimiani A., Carias L.L., Hujer A.M., Bethel C.R., Hujer K.M., Perez F., et al. Presence of plasmid-mediated quinolone resistance in Klebsiella pneumoniae isolates possessing blaKPC in the United States. Antimicrob Agents Chemother 2008, 52:2680-2682.
5. European Committee on Antimicrobial Susceptibility Testing.(EUCAST) Breakpoint tables for interpretation of MICs and zone diameters, Version 2.1. 2014, Rafael, CA: EUCAST.
6. Hu L., Zhong Q., Tu J., Xu Y., Qin Z., Parsons C., et al. Emergence of blaNDM-1 among Klebsiella pneumoniae ST15 and novel ST1031 clinical isolates in China. Diagn Microbiol Infect Dis 2013, 75:373-376.
7. Hu F., Zhu D., Wang F., Jiang X., Sun Z., Chen Z., et al. CHINET 2013 surveillance of bacterial resistance in China. Chin J Infect Chemother 2014, 14:365-374.
8. Jacoby G.A. AmpC beta-lactamases. Clin Microbiol Rev 2009, 22:161-182. [Table of Contents].
9. Li B., Yi Y., Wang Q., Woo P.C., Tan L., Jing H., et al. Analysis of drug resistance determinants in Klebsiella pneumoniae isolates from a tertiary-care hospital in Beijing, China. PLoS One 2012, 7:e42280.
10. Li J.J., Sheng Z.K., Deng M., Bi S., Hu F.S., Miao H.F., et al. Epidemic of Klebsiella pneumoniae ST11 clone coproducing KPC-2 and 16S rRNA methylase RmtB in a Chinese University Hospital. BMC Infect Dis 2012, 12:373-379.
11. Li J., Wang T., Shao B., Shen J., Wang S., Wu Y. Plasmid-mediated quinolone resistance genes and antibiotic residues in wastewater and soil adjacent to swine feedlots: potential transfer to agricultural lands. Environ Health Perspect 2012, 120:1144-1149.
12. Magiorakos A.P., Srinivasan A., Carey R.B., Carmeli Y., Falagas M.E., Giske C.G., et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012, 18:268-281.
13. Mahrouki S., Belhadj O., Chihi H., Mohamed B.M., Celenza G., Amicosante G., et al. Chromosomal blaCTX-M-(1)(5) associated with ISEcp1 in Proteus mirabilis and Morganella morganii isolated at the Military Hospital of Tunis, Tunisia. J Med Microbiol 2012, 61:1286-1289.
14. Mezzatesta M.L., Gona F., Caio C., Adembri C., Dell'utri P., Santagati M., et al. Emergence of an extensively drug-resistant ArmA- and KPC-2-producing ST101 Klebsiella pneumoniae clone in Italy. J Antimicrob Chemother 2013, 68:1932-1934.
15. Naas T., Cuzon G., Villegas M.V., Lartigue M.F., Quinn J.P., Nordmann P. Genetic structures at the origin of acquisition of the beta-lactamase bla KPC gene. Antimicrob Agents Chemother 2008, 52:1257-1263.
16. Podschun R., Ullmann U. Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors. Clin Microbiol Rev 1998, 11:589-603.
17. Qi Y., Wei Z., Ji S., Du X., Shen P., Yu Y. ST11, the dominant clone of KPC-producing Klebsiella pneumoniae in China. J Antimicrob Chemother 2011, 66:307-312.
18. Rodriguez-Martinez J.M., Cano M.E., Velasco C., Martinez-Martinez L., Pascual A. Plasmid-mediated quinolone resistance: an update. J Infect Chemother 2011, 17:149-182.
19. Rouze A., Nseir S. Continuous control of tracheal cuff pressure for the prevention of ventilator-associated pneumonia in critically ill patients: where is the evidence?. Curr Opin Crit Care 2013, 19:440-447.
20. Shahcheraghi F., Nikbin V.S., Feizabadi M.M. Prevalence of ESBLs genes among multidrug-resistant isolates of Pseudomonas aeruginosa isolated from patients in Tehran. Microb Drug Resist 2009, 15:37-39.
21. Shi W., Li K., Ji Y., Jiang Q., Wang Y., Shi M., et al. Carbapenem and cefoxitin resistance of Klebsiella pneumoniae strains associated with porin OmpK36 loss and DHA-1 beta-lactamase production. Braz J Microbiol 2013, 44:435-442.
22. Tantry B.A., Rahiman S. Antibacterial resistance and trend of urinary tract pathogens to commonly used antibiotics in Kashmir Valley. West Indian Med J 2012, 61:703-707.
23. Wachino J., Yamane K., Kimura K., Shibata N., Suzuki S., Ike Y., et al. Mode of transposition and expression of 16S rRNA methyltransferase gene rmtC accompanied by ISEcp1. Antimicrob Agents Chemother 2006, 50:3212-3215.
24. Woodford N., Tierno P.M., Young K., Tysall L., Palepou M.F., Ward E., et al. Outbreak of Klebsiella pneumoniae producing a new carbapenem-hydrolyzing class A beta-lactamase, KPC-3, in a New York Medical Center. Antimicrob Agents Chemother 2004, 48:4793-4799.
25. Yu F., Wang L., Pan J., Yao D., Chen C., Zhu T., et al. Prevalence of 16S rRNA methylase genes in Klebsiella pneumoniae isolates from a Chinese teaching hospital: coexistence of rmtB and armA genes in the same isolate. Diagn Microbiol Infect Dis 2009, 64:57-63.
26. Zhang Y., Jiang X., Wang Y., Li G., Tian Y., Liu H., et al. Contribution of beta-lactamases and porin proteins OmpK35 and OmpK36 to carbapenem resistance in clinical isolates of KPC-2-producing Klebsiella pneumoniae. Antimicrob Agents Chemother 2014, 58:1214-1217.