Please use this identifier to cite or link to this item: http://hdl.handle.net/10397/80500
Title: Prevalence and phenotypic characterization of carbapenem-resistant Klebsiella pneumoniae strains recovered from sputum and fecal samples of ICU patients in Zhejiang Province, China
Authors: Shu, LB
Lu, Q
Sun, RH
Lin, LQ
Sun, QL
Hu, J
Zhou, HW
Chan, EWC 
Chen, S 
Zhang, R
Keywords: Carbapenem-resistant Klebsiella pneumoniae
Surveillance
Sputum
Feces
ICU
Resistance
Virulence
Issue Date: 2019
Publisher: Dove Medical Press
Source: Infection and drug resistance, 2019, v. 12, p. 11-18 How to cite?
Journal: Infection and drug resistance 
Abstract: Objective: To understand the prevalence and transmission of carbapenem-resistant Klebsiella pneumoniae (CRKP) in ICU patients in Zhejiang Province, China, and determined the genetic and phenotypic characteristics of these CRKP strains.
Materials and Methods: A total of 202 ICU patients from eight tertiary hospitals were recruited and 55 non-duplicate CRKP strains were collected during July and August in 2017. These strains were subjected to determination of MICs, carriage of carbapenemase genes and tet(A) variants, PFGE, MLST and virulence potential using G. mellonella larvae infection model.
Results: A total of 55 CRKP strains were recovered from 42 patients, representing a carriage rate of 20.8%. CRKP strains were recovered from both the intestinal and respiratory tract of 13 patients. Importantly, strains isolated from sputum and fecal samples often displayed identical PFGE profiles, suggesting that CRKP may also colonize the respiratory tract. The most dominant ST type of these CRKP strains was ST11, accounting for 78% (43/55) of the test strains. The majority of CRKP strains were resistant to multiple antibiotics, with the exception of tigecycline and ceftazidime/avibactam. Interestingly, 32 strains were found to harbor the let(A) variant, which is known to confer reduced tigecycline susceptibility. Assessment of the virulence potential of these CRKP strains by string test showed that Results were negative for 53 of the 55 test strains. However, further assessment of virulence potential using a G. mellonella larvae infection model showed that CRKP isolated from sputum consistently exhibited a higher virulence level than strains recovered from fecal samples
Conclusion: CRKP is highly prevalent in ICU patients in Zhejiang Province with strains isolated from respiratory exhibiting higher virulence potential than those from GI tract. These data provide essential insight into development of new infection control measures to halt the transmission of CRKP in clinical settings.
URI: http://hdl.handle.net/10397/80500
EISSN: 1178-6973
DOI: 10.2147/IDR.S175823
Rights: © 2019 Shu et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms. php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
The following publication Shu, L. B., Lu, Q., Sun, R. H., Lin, L. Q., Sun, Q. L., Hu, J., . . . Zhang, R. (2019). Prevalence and phenotypic characterization of carbapenem-resistant Klebsiella pneumoniae strains recovered from sputum and fecal samples of ICU patients in Zhejiang Province, China. Infection and Drug Resistance, 12, 11-18 is available at https://dx.doi.org/10.2147/IDR.S175823
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