The prevalence of carbapenemase genes and plasmid-mediated quinolone resistance determinants in carbapenem-resistant Enterobacteriaceae from five teaching hospitals in central China. (20th November 2013)

• 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: 2013-11-20
• Subjects: Carbapenemases, -- Enterobacteriaceae, -- quinolone resistance determinants; Communicable diseases -- Periodicals; Epidemiology -- Periodicals; 614.4
• DOI: 10.1017/S0950268813002975
• Languages: English
• ISSNs: 0950-2688

Abstract

SUMMARY: We investigated the prevalence of β -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 bla KPC-2, bla NDM-1, bla IMP-4, bla IMP-26 and bla IMP-8 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 bla KPC-2 and bla IMP-4, bla KPC-2 and bla IMP-26, bla KPC-2 and bla IMP-8, and bla KPC-2 and bla NDM-1, respectively. Eight of nine bla NDM-1 -positive isolates lacked carbapenemases by the modified Hodge test, while 27/28 isolates harbouring bla KPC-2 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 bla KPC-2 also carried bla DHA-1 and bla CMY-2 ). The positive rates of qnrS1, qnrA1, qnrB and aac- (6 / )- Ib-cr in CRE were 25·5%, 9·8%, 23·5% and 15·7%, respectively. In particular, 7/9 isolates harbouring bla NDM-1 were positive for these quinolone resistance genes, of which five carried qnrS1 and two carried qnrS1 and qnrB4 . All but two of 29 Klebsiella pneumoniae isolates were grouped into 20 clonal clusters by PFGE, with the predominant cluster accounting for four bla KPC-2- positive isolates distributed in the same hospital. We conclude that there is a high prevalence of bla NDM-1 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 bla KPC-2 and bla IMP-26 in a strain of Klebsiella oxytoca .