Characteristics of carbapenemase-producing Klebsiellapneumoniae causing neonatal infection in Shandong province, China
Characteristics of carbapenemase-producing Klebsiellapneumoniae causing neonatal infection in Shandong province, China
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山东省新生儿产碳青霉烯酶肺炎克雷伯菌感染特征
DOI：
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发表时间：
2017
影响因子：
2.7
通讯作者：
邵春红
中科院分区：
文献类型：
--
作者：
金炎;宋晓斐;刘义刚;王勇;张炳昌;范会;邵春红
The goal of the present study was to examine the char-.acteristics of carbapenem-resistant Klebsiella pneumoniae as a.cause of neonatal infection. A total of 37 carbapenem-resistant.Klebsiella pneumoniae‑positive newborns hospitalized in.Shandong Provincial Hospital, China between April 2011.and October 2013 were examined. Antibiotic susceptibility.testing was performed using the agar dilution method and.the Etest. Resistance genes were assessed by polymerase.chain reaction (PCR) and sequencing. Pulsed‑field gel elec-.trophoresis (PFGE) and multi-locus sequence typing (MLST).were used to determine the genotypes and homology of these.isolates. Plasmids were analyzed by PFGE and conjugation.experiments. The outer membrane proteins were examined by.PCR and SDS-PAGE. All of the isolates were revealed to be.resistant to the third and fourth generation cephalosporins and.piperacillin‑tazobactam. Tigecycline, colistin, levofloxacin.and amikacin were successful against all of the isolates. The.antibiotic resistance rates of aztreonam, gentamicin, trime-.thoprim-sulfamethoxazole and fosfomycin were 13.51, 48.64,.78.38 and 86.49%, respectively. Of the 37 cases, 25 isolates.(67.57%) were bla NDM-1 positive, 13 isolates (35.14%) were.bla IMP-4 positive and 1 isolate (2.70%) was bla IMP-8 positive. Two.isolates carried both bla NDM-1 and bla IMP-4. The isolate carrying.2-4 plasmids and bla NDM-1 and bla IMP-4 was transferable between.strains. SDS-PAGE data indicated that outer membrane.proteins remained present. PFGE revealed 7 distinct clusters,.and MLST reported the presence of ST20, ST17, ST54, ST705.and ST290 sequences, which indicated that there was clone.and plasmid spread between newborns. The main resistance.mechanism of carbapenem-resistant Klebsiella pneumoniae.was that the isolates expressed the carbapenemase resistance.of bla NDM-1 and bla IMP-4 genes. The current study indicates that.early detection of these genes may be helpful in infection.prevention and control.
