Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul 3:10:314.
doi: 10.3389/fcimb.2020.00314. eCollection 2020.

Dissemination of Carbapenemases (KPC, NDM, OXA-48, IMP, and VIM) Among Carbapenem-Resistant Enterobacteriaceae Isolated From Adult and Children Patients in China

Renru Han  1   2 , Qingyu Shi  1   2 , Shi Wu  1   2 , Dandan Yin  1   2 , Mingjia Peng  1   2 , Dong Dong  1   2 , Yonggui Zheng  1   2 , Yan Guo  1   2 , Rong Zhang  3 , Fupin Hu  1   2 ; China Antimicrobial Surveillance Network (CHINET) Study Group
Affiliations

Dissemination of Carbapenemases (KPC, NDM, OXA-48, IMP, and VIM) Among Carbapenem-Resistant Enterobacteriaceae Isolated From Adult and Children Patients in China

Renru Han et al. Front Cell Infect Microbiol. .

Abstract

This study aimed to investigate the dissemination and characteristics of blaKPC, blaNDM, blaOXA-48-like , blaIMP, and blaVIM among the carbapenem-resistant Enterobacteriaceae (CRE) strains isolated from adult and children patients. A total of 935 non-duplicate CRE strains were collected from 36 hospitals in 24 provinces or cities across China from 2016 to 2018. Antimicrobial susceptibility testing was performed by broth microdilution method and carbapenemase genes blaKPC, blaNDM, blaOXA-48-like , blaIMP, and blaVIM were screened by PCR and confirmed by DNA sequencing. Overall, carbapenemases were produced in 97.4% (911/935) of CRE strains, including KPC-2 (51.6%, 482/935), NDM (35.7%, 334/935), and OXA-48-like carbapenemases (7.3%, 68/935). Overall, the most prevalent carbapenemase gene was blaKPC-2 among Klebsiella pneumoniae (64.6%, 457/709) and the CRE strains isolated from adult patients (70.3%, 307/437), and blaNDM among Escherichia coli (96.0%, 143/149) and the CRE strains from children (49.0%, 247/498). The blaOXA-232-positive carbapenem-resistant K. pneumoniae (9.3%, 66/709) were all isolated from children. Sixteen strains were positive for blaIMP and 9 strains produced multiple carbapenemases. No strain was positive for blaVIM. Most of the CRE strains (>90%) were resistant to cephalosporins and carbapenems, more than half (>50%) were resistant to aminoglycosides and fluoroquinolones, but the majority (95.8 and 98.4%) were susceptible to polymyxin B and tigecycline. Ceftazidime-avibactam showed excellent in vitro activity against blaKPC-2 and blaOXA-48-like positive strains (100% susceptible). In China, KPC-2, NDM, and OXA-48-like carbapenemases were predominant among CRE clinical isolates. The most prevalent carbapenemase gene was blaKPC-2 among K. pneumoniae isolates from adult patients, and blaNDM among E. coli isolates from children.

Keywords: blaIMP; blaKPC-2; blaNDM; blaOXA-48-like; carbapenem-resistant Enterobacteriaceae.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The map of CRE clinical strains collected from 24 provinces or cities in China.
Figure 2
Figure 2
Carbapenemase distribution among the carbapenem-resistant Enterobacteriaceae strains isolated from adult and children patients.
See this image and copyright information in PMC

References

    1. Albiger B., Glasner C., Struelens M. J., Grundmann H., Monnet D. L. (2015). Carbapenemase-producing Enterobacteriaceae in Europe: assessment by national experts from 38 countries, May 2015. Euro. Surveill. 20. 10.2807/1560-7917.ES.2015.20.45.30062 - DOI - PubMed
    1. Biagi M., Wu T., Lee M., Patel S., Butler D., Wenzler E. (2019). Searching for the optimal treatment for metallo- and serine-beta-lactamase producing Enterobacteriaceae: Aztreonam in combination with ceftazidime-avibactam or meropenem-vaborbactam. Antimicrob. Agents Chemother. 63:e01426–19. 10.1128/AAC.01426-19 - DOI - PMC - PubMed
    1. Falagas M. E., Tansarli G. S., Karageorgopoulos D. E., Vardakas K. Z. (2014). Deaths attributable to carbapenem-resistant Enterobacteriaceae infections. Emerg. Infect. Dis. 20, 1170–1175. 10.3201/eid2007.121004 - DOI - PMC - PubMed
    1. Feil E. J. (2016). Enterobacteriaceae: joining the dots with pan-European epidemiology. Lancet Infect Dis. 17, 118–119. 10.1016/S1473-3099(16)30333-4 - DOI - PubMed
    1. Goodman K. E., Simner P. J., Tamma P. D., Milstone A. M. (2016). Infection control implications of heterogeneous resistance mechanisms in carbapenem-resistant Enterobacteriaceae (CRE). Expert. Rev. Anti. Infect. Ther. 14, 95–108. 10.1586/14787210.2016.1106940 - DOI - PubMed

Publication types

LinkOut - more resources