A Nosocomial Respiratory Infection Outbreak of Carbapenem-Resistant Escherichia coli ST131 With Multiple Transmissible blaKPC–2 Carrying Plasmids

作者：Lin Gong, Na Tang, Dongke Chen, Kaiwen Sun, Ruiting Lan, Wen Zhang, Haijian Zhou, Min Yuan, Xia Chen, Xiaofei Zhao, Jie Che, Xuemei Bai, Yunfei Zhang, Hongtao Xu, Timothy R. Walsh, Jinxing Lu, Jianguo Xu, Juan Li, Jie Feng · 发表于：Frontiers in Microbiology · 年份：2020 · DOI：10.3389/fmicb.2020.02068 · 被引用次数：32 · 研究领域：Antibiotic Resistance in Bacteria、Vibrio bacteria research studies、Antibiotics Pharmacokinetics and Efficacy

Escherichia coli sequence type 131 (ST131) is well known for its multidrug resistance profile. Carbapenems have been considered the treatment of choice for E. coli ST131 infections and resistance to carbapenems is now emerging due to the acquisition of carbapenemase. 45 carbapenem-resistant E. coli isolates were collected in a hospital. The resistance mechanisms, plasmid profiles and genetic relatedness of these strains were determined. Phylogenetic relationships between these strains were assessed by molecular profiling and aligned with patient clinical details. The genetic context of blaKPC-2 was analyzed to trace the potential dissemination of blaKPC-2.45 carbapenem-resistant E. coli ST131strains are closely related. Initially prevalent only in the ward E02, ST131 subsequently spread to other wards and multiple lineages evolved independently, resulting in a respiratory infection outbreak of carbapenem-resistant E. coli ST131. Eight of the 30 patients died within 28 days of the first E. coli ST131 isolation. The blaKPC-2 positive plasmid profiles suggest that the carbapenem resistance was due to the acquisition of transmissible plasmids pE0272_KPC and pE0171_KPC carrying blaKPC-2 by E. coli ST131. Additionally, diverse multidrug resistance elements were transferred and rearranged between these plasmids mediated by IS26. E. coli ST131 has become a multidrug resistant epidemic clone that can cause hospital-acquired respiratory infections resulting in mortality. Our research i...