Infection and Drug Resistance (Apr 2023)
Epidemiological and Molecular Characteristics of blaNDM-1 and blaKPC-2 Co-Occurrence Carbapenem-Resistant Klebsiella pneumoniae
Abstract
Fang Rong,1,2,* Ziyi Liu,3,4,* Pengbin Yang,3,4 Feng Wu,5 Yu Sun,5 Xuewei Sun,5 Jun Zhou5 1Department of General Practice, The Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, People’s Republic of China; 2Graduate School Department of Dalian Medical University, Dalian, Liaoning, People’s Republic of China; 3Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu, People’s Republic of China; 4Institute of Comparative Medicine, Yangzhou University, Yangzhou, Jiangsu, People’s Republic of China; 5Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jun Zhou, Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Yangzhou University, Yangzhou University, 368 Hanjiang Middle Road, Yangzhou, Jiangsu, 225009, People’s Republic of China, Email [email protected]: Carbapenem-resistant Klebsiella pneumoniae (CRKP) has emerged and spread worldwide. It can usually cause a serious threat complicating treatment options in clinical settings. However, treatment options are limited. The present study investigates the prevalence and genetic characteristics of blaNDM-1 and blaKPC-2 co-harboring clinical isolates of Klebsiella pneumoniae.Methods: In this study, Multiplex polymerase chain reaction (PCR) was performed to detect the carbapenem-resistant genes, and the broth microdilution method was used to determine the minimum inhibitory concentrations (MICs) of antibacterial drugs. The transferability of carbapenem-resistant phenotypes was examined using filter mating assays. Overall, we used Illumina sequencing to evaluate the epidemiological and molecular characteristics of blaNDM-1 and blaKPC-2 (genes encoding carbapenemase) co-occurrence in CRKP strains.Results: All strains exhibited resistance to carbapenems and other antibiotics. However, they were still susceptible to polymyxin E. Among them, 18 isolates were positive for blaKPC-2, blaNDM-1, and multiple virulence determinants, such as genes encoding the virulence factor aerobactin, yersiniabactin, and the regulator of the mucoid phenotype (rmpA and rmpA2). Whole genome sequencing revealed that the 18 CRKP strains belonged to ST11 and capsular serotype KL64, and could be grouped into two evolutionary branches. Furthermore, these strains displayed hypervirulence potential since all of them carried pLVPK-like plasmid.Conclusion: These findings suggested that ST11-KL64 CRKP strains are major threats in terms of nosocomial infections in this hospital. Hence, new strategies should be urgently developed to monitor, diagnose, and treat this high-risk CRKP clone.Keywords: Klebsiella pneumoniae, carbapenem resistance, illumina sequencing, blaKPC-2, blaNDM-1
