Epidemiological and molecular characteristics of carbapenem-resistant Klebsiella pneumoniae from pediatric patients in Henan, China

Jiayue Ma; Kaijie Gao; Mingchao Li; Juanjuan Zhou; Xiaorui Song; Yaodong Zhang; Zhidan Yu; Zengyuan Yu; Weyland Cheng; Wancun Zhang; Adong Shen; Junmei Yang; Huiqing Sun; Lifeng Li

doi:10.1186/s12941-024-00757-5

Annals of Clinical Microbiology and Antimicrobials (Nov 2024)

Epidemiological and molecular characteristics of carbapenem-resistant Klebsiella pneumoniae from pediatric patients in Henan, China

Jiayue Ma,
Kaijie Gao,
Mingchao Li,
Juanjuan Zhou,
Xiaorui Song,
Yaodong Zhang,
Zhidan Yu,
Zengyuan Yu,
Weyland Cheng,
Wancun Zhang,
Adong Shen,
Junmei Yang,
Huiqing Sun,
Lifeng Li

Affiliations

Jiayue Ma: Henan International Joint Laboratory of Children’s Infectious Diseases, Department of Neonatology, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital
Kaijie Gao: Zhengzhou Key Laboratory of Children’s Infection and Immunity, Department of Laboratory Medicine, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital
Mingchao Li: Henan International Joint Laboratory of Children’s Infectious Diseases, Department of Neonatology, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital
Juanjuan Zhou: Zhengzhou Key Laboratory of Children’s Infection and Immunity, Department of Laboratory Medicine, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital
Xiaorui Song: Henan International Joint Laboratory of Children’s Infectious Diseases, Department of Neonatology, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital
Yaodong Zhang: Henan International Joint Laboratory of Children’s Infectious Diseases, Department of Neonatology, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital
Zhidan Yu: Henan International Joint Laboratory of Children’s Infectious Diseases, Department of Neonatology, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital
Zengyuan Yu: Henan International Joint Laboratory of Children’s Infectious Diseases, Department of Neonatology, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital
Weyland Cheng: Henan International Joint Laboratory of Children’s Infectious Diseases, Department of Neonatology, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital
Wancun Zhang: Henan International Joint Laboratory of Children’s Infectious Diseases, Department of Neonatology, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital
Adong Shen: Henan International Joint Laboratory of Children’s Infectious Diseases, Department of Neonatology, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital
Junmei Yang: Zhengzhou Key Laboratory of Children’s Infection and Immunity, Department of Laboratory Medicine, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital
Huiqing Sun: Henan International Joint Laboratory of Children’s Infectious Diseases, Department of Neonatology, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital
Lifeng Li: Henan International Joint Laboratory of Children’s Infectious Diseases, Department of Neonatology, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital

DOI: https://doi.org/10.1186/s12941-024-00757-5
Journal volume & issue: Vol. 23, no. 1
pp. 1 – 14

Abstract

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Abstract Purpose Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an emerging global threat, whereas its epidemiological characteristics in children are rarely reported. This study aims to analyze clinical and epidemiological characteristics of CRKP from children in Henan, China. Methods CRKP strains were isolated from pediatric patients, and the antimicrobial susceptibility of CRKP was determined using broth microdilution methods. The epidemiological characteristics of CRKP, including specimen sources, clinical data, carbapenemase types, virulence factors, MLST and PBRT typing were analyzed. Results In total, 108 CRKP isolates were isolated from specimens including sputum, blood and urine, mainly from preterm pediatric department and internal medical intensive care unit (ICU). Newborns and staying in the ICU were risk factors for crude mortality. 107 isolates exhibited a multi-drug resistant (MDR) phenotype, and one isolate was extensively drug-resistant (XDR). Bacterial susceptibility to colistin, tigecycline and trimethoprim/sulfamethoxazole was 98.10%, 78.50% and 91.43%, respectively. Carbapenemase bla KPC (86.11%) was predominant, followed by bla NDM (5.56%) and bla IMP (2.78%). Two strains co-harbored bla KPC-bla NDM, one had bla KPC-bla IMP, whereas three isolates did not carry any of the analyzed carbapenemase genes. All strains possessed fimH, and 98% of the isolates possessed mrkD. Hypervirulent factors rmpA2 and iucA showed high positive rates (71.30% and 49.07%), with 48.15% of strains containing both genes. MLST analysis identified nine distinct sequence types (STs), with ST11 (82.41%) being the most common, followed by ST2154 (4.63%) and ST307 (3.70%). PBRT analysis revealed IncFII (85.19%) as the most prevalent plasmid. Conclusion In summary, this study reported the epidemiological features of CRKP in pediatric patients in Henan, China, highlighting the high prevalence of multi-drug-resistant and hypervirulent strains, and underscoring the significance of continuous surveillance.

Published in Annals of Clinical Microbiology and Antimicrobials

ISSN: 1476-0711 (Online)
Publisher: BMC
Country of publisher: United Kingdom
LCC subjects: Medicine: Therapeutics. Pharmacology; Medicine: Internal medicine: Infectious and parasitic diseases; Science: Microbiology
Website: http://ann-clinmicrob.biomedcentral.com

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