Molecular Epidemiology and Characterization of Carbapenemase-Producing Enterobacteriaceae Isolated at a University Hospital in Korea during 4-Year Period.
- Author:
Sunyoung AHN
1
;
Ji Yeon SUNG
;
Hyunsoo KIM
;
Myung Sook KIM
;
Younjee HWANG
;
Sori JONG
;
Younghee SEO
;
Eunjin HA
;
Eun Suk PARK
;
Jun Yong CHOI
;
Dongeun YONG
;
Kyungwon LEE
Author Information
- Publication Type:Original Article
- Keywords: Beta-lactamase KPC; Carbapenem resistance; Enterobacteriaceae; Klebsiella pneumoniae
- MeSH: Academies and Institutes; Agar; Carbapenems; Diffusion; Drug Resistance, Bacterial; Electrophoresis, Gel, Pulsed-Field; Enterobacteriaceae*; Epidemiology; Infection Control; Klebsiella pneumoniae; Korea*; Methods; Molecular Epidemiology*; Multilocus Sequence Typing; Pneumonia; Polymerase Chain Reaction; Prevalence; Sequence Analysis
- From:Annals of Clinical Microbiology 2016;19(2):39-47
- CountryRepublic of Korea
- Language:Korean
- Abstract: BACKGROUND: Carbapenemase-producing Enterobacteriaceae (CPE) has been increasingly reported worldwide in the past 10 years, which is an important infection control concern. Since the epidemiology and characteristics of these CPEs vary according to institutes, we aimed to characterize CPEs in a university hospital during the recent 4 years. METHODS: From October 2011 to September 2015, CPE isolates from clinical specimens and hospital surveillance cultures were collected. Carbapenem resistance was confirmed by disk diffusion method and Minimal Inhibitory Concentration (MIC) was determined by agar dilution method. Carbapenemase production was tested by double disk test using aminophenylboronic acid and dipicolic acid. PCR and sequence analysis were performed to detect bla(KPC), bla(IMP-1), bla(VIM-2), bla(NDM-1)-like genes and bla(OXA-48) gene. Pulsed-field gel electrophoresis (PFGE) and Multilocus sequence typing (MLST) were conducted for KPC-producing Klebsiella pneumoniae isolates. RESULTS: Twenty-five isolates (11%) of CPE were identified among 222 carbapenem-resistant Enterobacteriacae isolates during the study period. The most prevalent CPE was KPC-producing K. pneumonia and others were IMP-1, VIM-2, NDM-1 type and OXA-48 producing CPEs. Most of these CPEs showed resistance to carbapenems with variable MICs. The sequence types (STs) of KPC-producing K. pneumoniae were ST307 and ST11. The PFGE of ST11 and ST307 showed clonality in each group suggesting the possibility of in-hospital outbreak. CONCLUSION: The prevalence of CPE has been increasing. In our institute, KPC-producing K. pneumoniae was the most frequently isolated CPE in the recent 4 years. CPE including KPC producers can easily transfer their resistance. Therefore continuous monitoring and more intensified infection control for CPE should be considered.
