The prevalence of carbapenemase genes and plasmid-mediated quinolone resistance determinants in carbapenem-resistant Enterobacteriaceae from five teaching hospitals in central China. (September 2014)

• Record Type: Journal Article
• Authors: HU, L.; ZHONG, Q.; SHANG, Y.; WANG, H.; NING, C.; LI, Y.; HANG, Y.; XIONG, J.; WANG, X.; XU, Y.; QIN, Z.; PARSONS, C.; WANG, L.; YU, F.
• Is Part Of: Epidemiology and infection. Volume 142:Number 9(2014:Sep.)
• Page Start: 1972
• Page End: 1977
• Publication Date: 2014-09
• Subjects: Communicable diseases -- Periodicals; Epidemiology -- Periodicals; 614.4
• DOI: 10.1017/S0950268813002975
• Languages: English
• ISSNs: 0950-2688

Abstract

<abstract abstract-type="normal"> <title>SUMMARY</title> <p>We investigated the prevalence of <italic>β</italic>-lactamase genes and plasmid-mediated quinolone resistance (PMQR) determinants in 51 carbapenem-resistant Enterobacteriaceae (CRE) from five teaching hospitals in central China. The prevalence of carbapenem resistance in Enterobacteriaceae was 1·0% (51/5012). Of 51 CRE, 31 (60·8%) isolates were positive for one tested carbapenemase gene, while 10 (19·6%) were simultaneously positive for two tested carbapenemase genes. The positive rates of <italic>bla</italic><sub>KPC-2</sub>, <italic>bla</italic><sub>NDM-1</sub>, <italic>bla</italic><sub>IMP-4</sub>, <italic>bla</italic><sub>IMP-26</sub> and <italic>bla</italic><sub>IMP-8</sub> were 54·9%, 17·6%, 11·8%, 11·8% and 3·9%, respectively. Of 10 CRE with two carbapenemase genes, three, five, one and one were positive for <italic>bla</italic><sub>KPC-2</sub> and <italic>bla</italic><sub>IMP-4</sub>, <italic>bla</italic><sub>KPC-2</sub> and <italic>bla</italic><sub>IMP-26</sub>, <italic>bla</italic><sub>KPC-2</sub> and <italic>bla</italic><sub>IMP-8</sub>, and <italic>bla</italic><sub>KPC-2</sub> and <italic>bla</italic><sub>NDM-1</sub>, respectively. Eight of nine <italic>bla</italic><sub>NDM-1</sub>-positive isolates lacked carbapenemases by the modified Hodge test, while 27/28 isolates harbouring <italic>bla</italic><sub>KPC-2</sub> were positive for carbapenemases determined by this test; 41·2% of the CRE-positive isolates also harboured ESBL genes in various combinations (three and two positive for <italic>bla</italic><sub>KPC-2</sub> also carried <italic>bla</italic><sub>DHA-1</sub> and <italic>bla</italic><sub>CMY-2</sub>). The positive rates of <italic>qnrS1, qnrA1, qnrB</italic> and <italic>aac-</italic>(6<sup>/</sup>)-<italic>Ib-cr</italic> in CRE were 25·5%, 9·8%, 23·5% and 15·7%, respectively. In particular, 7/9 isolates harbouring <italic>bla</italic><sub>NDM-1</sub> were positive for these quinolone resistance genes, of which five carried <italic>qnrS1</italic> and two carried <italic>qnrS1</italic> and <italic>qnrB4</italic>. All but two of 29 <italic>Klebsiella pneumoniae</italic> isolates were grouped into 20 clonal clusters by PFGE, with the predominant cluster accounting for four <italic>bla</italic><sub>KPC-2-</sub>positive isolates distributed in the same hospital. We conclude that there is a high prevalence of <italic>bla</italic><sub>NDM-1</sub> and PMQR determinants in CRE isolates in central China. Multiple resistance determinants in various combinations co-exist in these strains and we report for the first time the co-existence of <italic>bla</italic><sub>KPC-2</sub> and <italic>bla</italic><sub>IMP-26</sub> in a strain of <italic>Klebsiella oxytoca</italic>.</p> </abstract>