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. 2019 Feb 19;9(1):2271.
doi: 10.1038/s41598-018-38295-8.

Assessing Molecular Epidemiology of Carbapenem-resistant Klebsiella pneumoniae (CR-KP) with MLST and MALDI-TOF in Central China

Xiujuan Meng  1 , Jun Yang  2 , Juping Duan  1 , Sidi Liu  1 , Xun Huang  1 , Ximao Wen  1 , Xin Huang  1 , Chenchao Fu  1 , Jie Li  1 , Qingya Dou  1 , Yao Liu  1 , Jia Wang  2 , Qun Yan  3 , Mingxiang Zou  3 , Wenen Liu  3 , Zhong Peng  4 , Liang Chen  5 , Chunhui Li  6 , Anhua Wu  7
Affiliations

Assessing Molecular Epidemiology of Carbapenem-resistant Klebsiella pneumoniae (CR-KP) with MLST and MALDI-TOF in Central China

Xiujuan Meng et al. Sci Rep. .

Abstract

Carbapenem-resistant K. pneumoniae (CR-KP) posts significant public health challenge worldwide. The aim of this study is to assess clinical characteristics and molecular epidemiology of CR-KP infections with Multilocus sequence typing (MLST) and Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF) in Central China. A total of 71 CR-KP isolates were recovered in a teaching hospital from October 2014 to December 2015. Among all CR-KP isolates, 73.2% (52) produced K. pneumoniae carbapenemases-2 (KPC-2). Eighteen ST types were identified by MLST, among these ST types, forty-seven isolates belonged to ST11 type, which was the predominant outbreak strain in China, and most ST11 isolates produced KPC-2. Eleven mass spectrometry (MS) types were identified by MALDI-TOF MS analysis, 53.5% isolates were MS4 and MS6, which matched with ST11 in MLST analysis. CR-KP infection was associated with increased medical cost and longer hospitalization. Therefore, we found that KPC-2-producing ST11 (MS4 and MS6) CR-KP isolates were the predominant clone identified by MLST and MALDI-TOF, and CR-KP infection was associated with increased hospital costs and longer hospitalization.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
The distribution of carbapenem-resistant K. pneumoniae. The percentage of carbapenem-resistant K. pneumoniae (CR-KP) strains recovered from different wards and different sites are presented in this figure. Categorical variables in the figure are (no., %), ICU = intensive care unit.
Figure 2
Figure 2
Representative spectra of the carbapenem-resistant K. pneumoniae strains. A and B show spectra of two representative strains (the strains marked 1 and 2) in our study, respectively.
Figure 3
Figure 3
Magnified dendrogram (representation of hierarchical cluster analysis) of the carbapenem-resistant K. pneumoniae. ST types, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry types, resistant genes, and infection wards of the carbapenem-resistant K. pneumoniae strains are described.
Figure 4
Figure 4
Monthly distribution of multilocus sequence typing (ST) and mass spectrometry types (MS). A shows the distribution of ST types of multilocus sequence typing, ST11cluster and a peak period for outbreak in May and June 2015. B shows the distribution of mass spectrometry (MS) types, mainly MS6, MS4, and MS8 clusters.
See this image and copyright information in PMC

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