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An Outbreak of Carbapenem-Resistant Klebsiella pneumoniae of K57 Capsular Serotype in an Emergency Intensive Care Unit of a Teaching Hospital in China
The emergence of carbapenem-resistant hypervirulent K. pneumoniae (CR-hvKP) strains has increased the threat posed by K. pneumoniae. Here, we described an outbreak of 32 CR-hvKP isolates from the emergency intensive care unit (EICU) of a teaching hospital in China. Thirty-two CRKp isolates were coll...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8441004/ https://www.ncbi.nlm.nih.gov/pubmed/34540792 http://dx.doi.org/10.3389/fpubh.2021.724212 |
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author | Shao, Chunhong Jin, Yan Wang, Wei Jiang, Meijie Zhao, Shuping |
author_facet | Shao, Chunhong Jin, Yan Wang, Wei Jiang, Meijie Zhao, Shuping |
author_sort | Shao, Chunhong |
collection | PubMed |
description | The emergence of carbapenem-resistant hypervirulent K. pneumoniae (CR-hvKP) strains has increased the threat posed by K. pneumoniae. Here, we described an outbreak of 32 CR-hvKP isolates from the emergency intensive care unit (EICU) of a teaching hospital in China. Thirty-two CRKp isolates were collected from six patients and their surrounding environment in EICU. Antimicrobial susceptibility testing was performed using VITEK 2 compact system, E-test or the broth microdilution method. All isolates were serotyped, antimicrobial resistance genes and virulence-associated genes were screened using PCR. Multilocus sequence typing (MLST) and pulse-field gel electrophoresis (PFGE) were employed to characterize the genetic relationships among the CPKP isolates. The virulence capability of 11 CRKp isolates from six patients was evaluated through Galleria mellonella larva infection assay. PFGE showed that all 32 isolates belonged to one cluster, and MLST revealed that belonged to ST11. All isolates exhibited high resistance to β-lactam antibiotics, quinolones, and aminoglycosides. They were susceptible to ceftazidime/averbatan, tigecycline, and colistin. All 32 isolates harbored bla(KPC−2), bla(SHV−11), bla(TEM−1), rmtB, and qnrD. The serotype of all 32 isolates was K57. All 32 isolates contained 6 virulence genes, namely, fimH, iucB, mrkD, rmpA, uge, and wabG. Infection assays demonstrated high mortality in the Galleria mellonella model. Following measures implemented by the hospital, the outbreak was controlled. The mortality rate was 50.0%. The epidemiology of CR-hvKP should be monitored closely to detect early indications of this emerging public health threat. |
format | Online Article Text |
id | pubmed-8441004 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-84410042021-09-16 An Outbreak of Carbapenem-Resistant Klebsiella pneumoniae of K57 Capsular Serotype in an Emergency Intensive Care Unit of a Teaching Hospital in China Shao, Chunhong Jin, Yan Wang, Wei Jiang, Meijie Zhao, Shuping Front Public Health Public Health The emergence of carbapenem-resistant hypervirulent K. pneumoniae (CR-hvKP) strains has increased the threat posed by K. pneumoniae. Here, we described an outbreak of 32 CR-hvKP isolates from the emergency intensive care unit (EICU) of a teaching hospital in China. Thirty-two CRKp isolates were collected from six patients and their surrounding environment in EICU. Antimicrobial susceptibility testing was performed using VITEK 2 compact system, E-test or the broth microdilution method. All isolates were serotyped, antimicrobial resistance genes and virulence-associated genes were screened using PCR. Multilocus sequence typing (MLST) and pulse-field gel electrophoresis (PFGE) were employed to characterize the genetic relationships among the CPKP isolates. The virulence capability of 11 CRKp isolates from six patients was evaluated through Galleria mellonella larva infection assay. PFGE showed that all 32 isolates belonged to one cluster, and MLST revealed that belonged to ST11. All isolates exhibited high resistance to β-lactam antibiotics, quinolones, and aminoglycosides. They were susceptible to ceftazidime/averbatan, tigecycline, and colistin. All 32 isolates harbored bla(KPC−2), bla(SHV−11), bla(TEM−1), rmtB, and qnrD. The serotype of all 32 isolates was K57. All 32 isolates contained 6 virulence genes, namely, fimH, iucB, mrkD, rmpA, uge, and wabG. Infection assays demonstrated high mortality in the Galleria mellonella model. Following measures implemented by the hospital, the outbreak was controlled. The mortality rate was 50.0%. The epidemiology of CR-hvKP should be monitored closely to detect early indications of this emerging public health threat. Frontiers Media S.A. 2021-09-01 /pmc/articles/PMC8441004/ /pubmed/34540792 http://dx.doi.org/10.3389/fpubh.2021.724212 Text en Copyright © 2021 Shao, Jin, Wang, Jiang and Zhao. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Public Health Shao, Chunhong Jin, Yan Wang, Wei Jiang, Meijie Zhao, Shuping An Outbreak of Carbapenem-Resistant Klebsiella pneumoniae of K57 Capsular Serotype in an Emergency Intensive Care Unit of a Teaching Hospital in China |
title | An Outbreak of Carbapenem-Resistant Klebsiella pneumoniae of K57 Capsular Serotype in an Emergency Intensive Care Unit of a Teaching Hospital in China |
title_full | An Outbreak of Carbapenem-Resistant Klebsiella pneumoniae of K57 Capsular Serotype in an Emergency Intensive Care Unit of a Teaching Hospital in China |
title_fullStr | An Outbreak of Carbapenem-Resistant Klebsiella pneumoniae of K57 Capsular Serotype in an Emergency Intensive Care Unit of a Teaching Hospital in China |
title_full_unstemmed | An Outbreak of Carbapenem-Resistant Klebsiella pneumoniae of K57 Capsular Serotype in an Emergency Intensive Care Unit of a Teaching Hospital in China |
title_short | An Outbreak of Carbapenem-Resistant Klebsiella pneumoniae of K57 Capsular Serotype in an Emergency Intensive Care Unit of a Teaching Hospital in China |
title_sort | outbreak of carbapenem-resistant klebsiella pneumoniae of k57 capsular serotype in an emergency intensive care unit of a teaching hospital in china |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8441004/ https://www.ncbi.nlm.nih.gov/pubmed/34540792 http://dx.doi.org/10.3389/fpubh.2021.724212 |
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