Abstract
BackgroundThe enhancing incidence of carbapenem-resistant Klebsiella pneumoniae (CRKP)-mediated infections in Mengchao Hepatobiliary Hospital of Fujian Medical University in 2017 is the motivation behind this investigation to study gene phenotypes and resistance-associated genes of emergence regarding the CRKP strains. In current study, seven inpatients are enrolled in the hospital with complete treatments. The carbapenem-resistant K. pneumoniae whole genome is sequenced using MiSeq short-read and Oxford Nanopore long-read sequencing technology. Prophages are identified to assess genetic diversity within CRKP genomes.ResultsThe investigation encompassed eight CRKP strains that collected from the patients enrolled as well as the environment, which illustrate that blaKPC-2 is responsible for phenotypic resistance in six CRKP strains that K. pneumoniae sequence type (ST11) is informed. The plasmid with IncR, ColRNAI and pMLST type with IncF[F33:A-:B-] co-exist in all ST11 with KPC-2-producing CRKP strains. Along with carbapenemases, all K. pneumoniae strains harbor two or three extended spectrum β-lactamase (ESBL)-producing genes. fosA gene is detected amongst all the CRKP strains. The single nucleotide polymorphisms (SNP) markers are indicated and validated among all CRKP strains, providing valuable clues for distinguishing carbapenem-resistant strains from conventional K. pneumoniae.ConclusionsST11 is the main CRKP type, and blaKPC-2 is the dominant carbapenemase gene harbored by clinical CRKP isolates from current investigations. The SNP markers detected would be helpful for characterizing CRKP strain from general K. pneumoniae. The data provides insights into effective strategy developments for controlling CRKP and nosocomial infection reductions.
Highlights
The enhancing incidence of carbapenem-resistant Klebsiella pneumoniae (CRKP)-mediated infections in Mengchao Hepatobiliary Hospital of Fujian Medical University in 2017 is the motivation behind this investigation to study gene phenotypes and resistance-associated genes of emergence regarding the CRKP strains
In conclusion, ST11 is the main CRKP type, and blaKPC-2 is the dominant carbapenemase gene harbored by clinical CRKP isolates of current investigation
All K. pneumoniae strains harbor two or three ESBLs-producing genes, which indicate that all isolates contain multiple ESBLs resistance genes. fosA genes are found among all the CRKP strains, which may infer that fosfomycin-modifying enzymes account for a majority of the fosfomycin resistance and that CRKP strains are resistant to fosfomycin
Summary
The enhancing incidence of carbapenem-resistant Klebsiella pneumoniae (CRKP)-mediated infections in Mengchao Hepatobiliary Hospital of Fujian Medical University in 2017 is the motivation behind this investigation to study gene phenotypes and resistance-associated genes of emergence regarding the CRKP strains. Carbapenem-resistant Enterobacteriaceae (CRE) is reported as a consequence mainly due to acquisition of carbapenemase genes, and CRE is inferred as an urgent threat to human health by the Centers for Disease Control and Prevention (CDC), USA in 2013. Carbapenems such as imipenem, meropenem, and biapenem represent the first-line treatment of serious infections caused by multi-resistant Enterobacteriaceae including Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli) [2]. Whereas carbapenems can be hydrolyzed by carbapenemase in carbapenem-resistant K. pneumoniae (CRKP) [3], which results in resistance to βLactam antibiotics including carbapenem. Among Ambler class A β-lactamases, plasmid-mediated KPC has
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