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Outbreak of IncX8 Plasmid–Mediated KPC-3–Producing Enterobacterales Infection, China

Carbapenem-resistant Enterobacterales (CRE) infection is highly endemic in China; Klebsiella pneumoniae carbapenemase (KPC) 2–producing CRE is the most common, whereas KPC-3–producing CRE is rare. We report an outbreak of KPC-3–producing Enterobacterales infection in China. During August 2020–June 2...

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Autores principales: Chen, Lan, Ai, Wenxiu, Zhou, Ying, Wu, Chunyang, Guo, Yinjuan, Wu, Xiaocui, Wang, Bingjie, Rao, Lulin, Xu, Yanlei, Zhang, Jiao, Chen, Liang, Yu, Fangyou
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Centers for Disease Control and Prevention 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239885/
https://www.ncbi.nlm.nih.gov/pubmed/35731165
http://dx.doi.org/10.3201/eid2807.212181
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author Chen, Lan
Ai, Wenxiu
Zhou, Ying
Wu, Chunyang
Guo, Yinjuan
Wu, Xiaocui
Wang, Bingjie
Rao, Lulin
Xu, Yanlei
Zhang, Jiao
Chen, Liang
Yu, Fangyou
author_facet Chen, Lan
Ai, Wenxiu
Zhou, Ying
Wu, Chunyang
Guo, Yinjuan
Wu, Xiaocui
Wang, Bingjie
Rao, Lulin
Xu, Yanlei
Zhang, Jiao
Chen, Liang
Yu, Fangyou
author_sort Chen, Lan
collection PubMed
description Carbapenem-resistant Enterobacterales (CRE) infection is highly endemic in China; Klebsiella pneumoniae carbapenemase (KPC) 2–producing CRE is the most common, whereas KPC-3–producing CRE is rare. We report an outbreak of KPC-3–producing Enterobacterales infection in China. During August 2020–June 2021, 25 bla(KPC-3)–positive Enterobacteriale isolates were detected from 24 patients in China. Whole-genome sequencing analysis revealed that the bla(KPC-3) genes were harbored by IncX8 plasmids. The outbreak involved clonal expansion of KPC-3–producing Serratia marcescens and transmission of bla(KPC-3) plasmids across different species. The bla(KPC-3) plasmids demonstrated high conjugation frequencies (10(−3) to 10(−4)). A Galleria mellonella infection model showed that 2 sequence type 65 K2 K. pneumoniae strains containing bla(KPC-3) plasmids were highly virulent. A ceftazidime/avibactam in vitro selection assay indicated that the KPC-3–producing strains can readily develop resistance. The spread of bla(KPC-3)–harboring IncX8 plasmids and these KPC-3 strains should be closely monitored in China and globally.
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spelling pubmed-92398852022-07-06 Outbreak of IncX8 Plasmid–Mediated KPC-3–Producing Enterobacterales Infection, China Chen, Lan Ai, Wenxiu Zhou, Ying Wu, Chunyang Guo, Yinjuan Wu, Xiaocui Wang, Bingjie Rao, Lulin Xu, Yanlei Zhang, Jiao Chen, Liang Yu, Fangyou Emerg Infect Dis Research Carbapenem-resistant Enterobacterales (CRE) infection is highly endemic in China; Klebsiella pneumoniae carbapenemase (KPC) 2–producing CRE is the most common, whereas KPC-3–producing CRE is rare. We report an outbreak of KPC-3–producing Enterobacterales infection in China. During August 2020–June 2021, 25 bla(KPC-3)–positive Enterobacteriale isolates were detected from 24 patients in China. Whole-genome sequencing analysis revealed that the bla(KPC-3) genes were harbored by IncX8 plasmids. The outbreak involved clonal expansion of KPC-3–producing Serratia marcescens and transmission of bla(KPC-3) plasmids across different species. The bla(KPC-3) plasmids demonstrated high conjugation frequencies (10(−3) to 10(−4)). A Galleria mellonella infection model showed that 2 sequence type 65 K2 K. pneumoniae strains containing bla(KPC-3) plasmids were highly virulent. A ceftazidime/avibactam in vitro selection assay indicated that the KPC-3–producing strains can readily develop resistance. The spread of bla(KPC-3)–harboring IncX8 plasmids and these KPC-3 strains should be closely monitored in China and globally. Centers for Disease Control and Prevention 2022-07 /pmc/articles/PMC9239885/ /pubmed/35731165 http://dx.doi.org/10.3201/eid2807.212181 Text en https://creativecommons.org/licenses/by/4.0/Emerging Infectious Diseases is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.
spellingShingle Research
Chen, Lan
Ai, Wenxiu
Zhou, Ying
Wu, Chunyang
Guo, Yinjuan
Wu, Xiaocui
Wang, Bingjie
Rao, Lulin
Xu, Yanlei
Zhang, Jiao
Chen, Liang
Yu, Fangyou
Outbreak of IncX8 Plasmid–Mediated KPC-3–Producing Enterobacterales Infection, China
title Outbreak of IncX8 Plasmid–Mediated KPC-3–Producing Enterobacterales Infection, China
title_full Outbreak of IncX8 Plasmid–Mediated KPC-3–Producing Enterobacterales Infection, China
title_fullStr Outbreak of IncX8 Plasmid–Mediated KPC-3–Producing Enterobacterales Infection, China
title_full_unstemmed Outbreak of IncX8 Plasmid–Mediated KPC-3–Producing Enterobacterales Infection, China
title_short Outbreak of IncX8 Plasmid–Mediated KPC-3–Producing Enterobacterales Infection, China
title_sort outbreak of incx8 plasmid–mediated kpc-3–producing enterobacterales infection, china
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239885/
https://www.ncbi.nlm.nih.gov/pubmed/35731165
http://dx.doi.org/10.3201/eid2807.212181
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