Outbreak of KPC-2–Producing Klebsiella pneumoniae ST76 Isolates in an Intensive Care Unit and Neurosurgery Unit

作者：Shanshan Su, Chunjiang Li, Yongxin Zhao, Lan Yu, Yong Wang, Yuchao Wang, Mingjia Bao, Yu Fu, Jisheng Zhang, Xiaoli Zhang · 发表于：Microbial Drug Resistance · 年份：2020 · DOI：10.1089/mdr.2019.0363 · 被引用次数：20 · 研究领域：Antibiotic Resistance in Bacteria、Enterobacteriaceae and Cronobacter Research、Bacterial biofilms and quorum sensing

Background: The aim of this study was to investigate the characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP) ST76 isolates collected during an outbreak in a hospital's intensive care unit and neurosurgery unit. Methods: Seventeen separate clinical isolates of CRKP were collected from patients from March 2016 to February 2017. Bacterial isolates were identified, and antimicrobial susceptibility testing was conducted using the VITEK-2 compact system. Isolates containing antibiotic resistance genes were characterized by polymerase chain reaction and DNA sequencing. Clonal relatedness was assessed by multilocus sequence typing and pulsed-field gel electrophoresis. Conjugation experiments were performed to determine the transferability of plasmids with antibiotic resistance. The genomic features and mobile genetic elements of ST76 CRKP were detected by whole genome sequencing. Results: ST76 KPC-2–producing CRKP prevailed in our hospital, causing an outbreak. The strains also carried bla SHV-1 , bla CTX-M-15 , bla TEM-1 , qnrB , and acc(6′)Ib-cr resistance genes. Plasmids from 17.7% of the isolated strains bearing these resistance genes could be transferred into the recipient Escherichia coli J53 through conjugation. Sequencing results showed that the KP4 genome mainly consisted of a circular chromosome and three antibiotic resistance plasmids. The plasmid carrying the bla KPC-2 gene was located on a 437 kb IncFIB (pQil) plasmid with Tn 1721 - bla KPC-2 -ΔT 3 gene ...