Abstract
Carbapenem-resistant K. pneumoniae (CR-KP) posts significant public health challenge worldwide. The aim of this study is to assess clinical characteristics and molecular epidemiology of CR-KP infections with Multilocus sequence typing (MLST) and Matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF) in Central China. A total of 71 CR-KP isolates were recovered in a teaching hospital from October 2014 to December 2015. Among all CR-KP isolates, 73.2% (52) produced K. pneumoniae carbapenemases-2 (KPC-2). Eighteen ST types were identified by MLST, among these ST types, forty-seven isolates belonged to ST11 type, which was the predominant outbreak strain in China, and most ST11 isolates produced KPC-2. Eleven mass spectrometry (MS) types were identified by MALDI-TOF MS analysis, 53.5% isolates were MS4 and MS6, which matched with ST11 in MLST analysis. CR-KP infection was associated with increased medical cost and longer hospitalization. Therefore, we found that KPC-2-producing ST11 (MS4 and MS6) CR-KP isolates were the predominant clone identified by MLST and MALDI-TOF, and CR-KP infection was associated with increased hospital costs and longer hospitalization.
Highlights
K. pneumoniae causes healthcare-associated infections (HAIs), especially in newborns, hematological malignancies patients, and immunocompromised patients[1,2]
Zheng B et al studied the molecular epidemiology of carbapenem-resistant K. pneumoniae (CR-KP) in Eastern China using Pulsed Field Gel Electrophoresis (PFGE)[13], data on the epidemiology and molecular characteristics of CR-KP infection in central China are lacking, especially, molecular epidemiology of CR-KP using matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS)
The majority of patients with CR-KP infection were from the intensive care unit (ICU) wards (24) and medical wards (19), followed by surgery wards (10), pediatric wards (7), transplantation wards (6), burn wards (3) and tumor wards (2)
Summary
K. pneumoniae causes healthcare-associated infections (HAIs), especially in newborns, hematological malignancies patients, and immunocompromised patients[1,2]. In China, the majority of CR-KP strains acquire resistance to carbapenem by producing KPCs9–11. KPC-producing organisms are clinically important because of the limited treatment options available and the high mortality rate caused by these organisms infection. Zheng B et al studied the molecular epidemiology of CR-KP in Eastern China using Pulsed Field Gel Electrophoresis (PFGE)[13], data on the epidemiology and molecular characteristics of CR-KP infection in central China are lacking, especially, molecular epidemiology of CR-KP using matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS). The aim of the present study was to investigate the molecular epidemiology and clinical characteristics of 71 CR-KP isolates in a teaching hospital in Changsha, central China using MALDI-TOF MS and MLST. This study identified antimicrobial resistance genes of CR-KP strains, and investigated the financial burden of CR-KP infection
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