Shift in the dominant sequence type of carbapenem-resistant Klebsiella pneumonia infection from ST278-NDM-1 to ST11-KPC-2 in neonatal patients in a children’s hospital in Shanghai, China, 2017–2021
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Lijun Yin [1] ; Lu Lu [1] ; Leiyan He [1] ; Laishuan Wang [1] ; Guoping Lu [1] ; Yun Cao [1] ; Xiaowen Zhai [1] ; Chuanqing Wang [1]
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[1] Children's Hospital of Fudan University
Children's Hospital of Fudan University
China
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- Localización: International microbiology: official journal of the Spanish Society for Microbiology, ISSN 1139-6709, Vol. 27, Nº. 3, 2024, págs. 871-881
- Idioma: inglés
- Enlaces
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Resumen
Objectives To investigate the clinical characteristics and molecular epidemiology of CRKP infection in neonatal patients in a children’s hospital in China from 2017 to 2021.
Methods Species identification and antibiotic susceptibilities were tested with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and VITEK 2 systems. The clinical data were collected from medical records. Carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates were investigated by antimicrobial susceptibility testing, carbapenemase genes and multilocus sequence typing.
Results Six kinds of resistant genes and 23 STs were detected. BlaNDM-1 (n=83, 55.3%) was the predominant carbapenemase gene, followed by blaKPC-2 (n=45, 30.0%), blaNDM-5 (n=7, 4.7%), blaIMP-38 (n=6, 4.0%). BlaNDM-1 was predominant in 2017 and 2018, whereas blaKPC-2 increased in 2019 and became the predominant gene from 2020 to 2021. ST11 accounted for most infections (n=35, 23.3%), followed by ST278 (n=23, 15.3%), ST17 (n=17, 11. 3%) and ST2735 (n=16, 10.7%). ST278 and ST17 were predominant in 2017 and 2018, whereas ST11 increased in 2019 and became the predominant sequence type from 2020 to 2021. Compared with blaNDM-1, the CRKP strains producing blaKPC-2 were characterized by high resistance to gentamicin, amikacin and levofloxacin and the change trend of drug resistance rate before and after COVID-19 was consistent with that of blaNDM-1 and blaKPC-2.
Conclusions The main sequence type of CRKP infection changed dynamically from ST278-NDM-1 to ST11-KPC-2 during the years 2017–2021 in the newborns. Antibiotic exposure and the prevalence of COVID-19 since 2020 may have led to changes in hospital population and lead to the changes.
