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. 2025 Apr 25:18:2105-2117.
doi: 10.2147/IDR.S507692. eCollection 2025.

Epidemiological Characteristics and Carbapenemase Analysis of Carbapenem-Resistant Enterobacterales Isolates in a Teaching Hospital in Guangzhou, China

Yiwen Li #  1 , Ying Mai #  1 , Yingxin Liu #  1 , Yueting Jiang  1
Affiliations

Epidemiological Characteristics and Carbapenemase Analysis of Carbapenem-Resistant Enterobacterales Isolates in a Teaching Hospital in Guangzhou, China

Yiwen Li et al. Infect Drug Resist. .

Abstract

Background: In this study, carbapenem-resistant Enterobacterales (CRE) were isolated from a teaching hospital in Guangzhou between January 2020 and March 2023, meticulously examining the antimicrobial resistance patterns, carbapenemase types, and epidemiological characteristics of these isolated strains. This comprehensive analysis serves as an invaluable insight for optimizing CRE treatment strategies for clinical practitioners and implementing robust measures to prevent and control nosocomial infections within healthcare settings.

Methods: The antimicrobial susceptibility testing aimed to ascertain carbapenem resistance in Enterobacterales, while the production of carbapenemase was assessed through rapid phenotypic identification by immunochromatographic assay (KPC, NDM, VIM, IMP, and OXA-48-like) and confirmed by PCR.

Results: Among the 300 CRE strains collected from January 2020 to March 2023, Klebsiella pneumoniae (CR-Kpn) accounted for 72.7%, Escherichia coli (CR-Eco) 12.3%, Enterobacter cloacae (CR-Ecl) 8.3%, Klebsiella aerogenes (CR-Eae) 2.3%, Citrobacter freundii (CR-Cfr) 2.0%, and others 2.3%. Among the five carbapenemase types, blaKPC-like ranked first accounting for 66.7%, followed by blaNDM-like (23.0%), blaOXA-48-like (0.7%), and blaIMP-like (0.7%), of which six strains of blaKPC-like plus blaNDM-like were detected simultaneously. Although blaKPC-like predominated in adults and the elderly, blaNDM-like was more common in children. These CRE strains showed high resistance to most antibiotics; however, they showed high sensitivity to tigecycline and colistin.

Conclusion: CRE strains exhibited a high resistance rate of multiple antibacterial drugs, and blaKPC-like were widely prevalent in CRE strains, particularly K. pneumoniae. Clinical attention should be paid to the rational use of antibacterial drugs, and CRE monitoring and hospital infection prevention and control should be continuously strengthened.

Keywords: CRE; KPC; antimicrobial resistance.

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Conflict of interest statement

The authors declare that they have no conflicts of interest in this work.

Figures

Figure 1
Figure 1
(A) Distribution ratios of CRE strains. (B) Proportion of specimens from CRE strains. (C) Proportion of specimens for the main strains of Klebsiella pneumoniae, Escherichia coli and Enterobacter cloacae. (D) Quantities of Klebsiella pneumoniae, Escherichia coli and Enterobacter cloacae strains between invasive and non-invasive infections.
Figure 2
Figure 2
Ratios of various carbapenemase of CRE strains (A), Klebsiella pneumoniae strains (B), Escherichia coli strains (C), Enterobacter cloacae strains (D).
Figure 3
Figure 3
MIC values of CRE strains against Meropenem (A) and Imipenem (B).
Figure 4
Figure 4
(A) Distribution of carbapenemase in different age groups. (B) The distribution of different carbapenemase in Kpn, Eco, Ecl strains at different ages. (C) The ratios of carbapenemase of Kpn, Eco, Ecl strains between invasive and non-invasive infection. Proportion of carbapenemase in Kpn (C) and Eco (D) strains in invasive versus non-invasive infections.
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