Rapid increase in occurrence of carbapenem-resistant Enterobacteriaceae in healthy rural residents in Shandong Province, China, from 2015 to 2017. (March 2022)

• Record Type: Journal Article
• Authors: Chen, Baoli; Berglund, Björn; Wang, Shuang; Börjesson, Stefan; Bi, Zhenqiang; Nilsson, Maud; Yin, Hong; Zheng, Beiwen; Xiao, Yonghong; Bi, Zhenwang; Nilsson, Lennart E.
• Is Part Of: Journal of global antimicrobial resistance. Volume 28(2022)
• Page Start: 38
• Page End: 42
• Publication Date: 2022-03
• Subjects: Drug resistance -- Carbapenems -- Enterobacteriaceae -- Escherichia coli -- Epidemiology -- China; Drug resistance -- Periodicals; Drug resistance -- Periodicals; Drug resistance; Periodicals; 616.9041
• DOI: 10.1016/j.jgar.2021.11.007
• Languages: English
• ISSNs: 2213-7165

Abstract

Highlights: Faeces of residents in rural Shandong, China, were screened for carbapenem-resistant Enterobacteriaceae (CRE). An increase in CRE carriage from 2.4% to 13.4% was observed from 2015 to 2017. Most CRE isolates (93.0%) were Escherichia coli . All CRE isolates carried NDM-type carbapenemase genes. ABSTRACT: Objectives: The global increase in carbapenem-resistant Enterobacteriaceae (CRE) is a growing health concern. Infections caused by CRE are associated with increased mortality and length of hospital stay, emphasising the health and economic burden posed by these pathogens. Although CRE can inhabit the human gut asymptomatically, colonisation with CRE is associated with an increased risk of CRE infection and mortality. In this study, we investigated the occurrence and characteristics of CRE in faecal samples from healthy persons in 12 villages in Shandong Province, China. Methods: Screening for CRE in faecal samples was performed by selective cultivation. Minimum inhibitory concentrations (MICs) of meropenem were determined by the agar dilution method. Multilocus sequence typing (MLST) and carbapenemase gene carriage of the isolates were determined by whole-genome sequencing. Genetic relatedness of Escherichia coli isolates was determined by core genome MLST. Results: CRE carriage increased from 2.4% in 2015 to 13.4% in 2017. Most CRE isolates (93.0%) were E. coli and all carried NDM-type carbapenemases. Sequence types (STs) among the E. coli isolates were diverse. The single most common ST was the highly epidemic strain ST167, which was only observed in 2017. Conclusion: We report a rapid increase in occurrence of CRE (from 2.4% to 13.4%) among faecal samples collected from healthy rural residents of Shandong Province from 2015 to 2017. Colonisation with CRE is known to increase the risk of CRE infection, and the worrying deterioration of the epidemiological situation in the region reported here indicates a need for further monitoring and possible interventions.