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Genomic and Phenotypic Diversity of carbapenemase-producing Enterobacteriaceae Isolates from Bacteremia in China: A Multicenter Epidemiological, Microbiological, and Genetic Study

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Engineering 2022年第5期8卷 90-100页

作者： Beiwen Zheng Hao Xu Lihua Guo Xiao Yu Jinru Ji Chaoqun Ying Yunbo Chen Ping Shen Huiming Han Chen Huang Shuntian Zhang Tao Lv Yonghong Xiao State Key Laboratory for Diagnosis and Treatment of Infectious Diseases Collaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesThe First Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhou 310003China Medical College of Beihua University Jilin 132013China Department of Infectious Diseases Ningbo Medical Center Li Huili HospitalNingbo 315040China

carbapenemase-producing Enterobacteriaceae(CPE) isolates are recognized as one of the most severe threats to public health. However, the population structure and genetic characteristics of CPE isolates among bloodstream infections(BSIs) are largely unknown. To address this knowledge gap, in this study,we included patients with clinically significant BSIs due to Enterobacterales isolates, recruited from 26 sentinel hospitals in China(2014–2015). CPE isolates were microbiologically and genomically characterized,including their susceptibility profiles, molecular typing, phylogenetic features, and genetic context analysis of carbapenemase-encoding genes. Of the 2569 BSI Enterobacterales isolates enrolled, 42(1.6%) were carbapenemase-positive. Moreover, among the 2242 investigated isolates, 1111(49.6%) extendedspectrum β-lactamase(ESBL)-producing isolates were identified in Escherichia coli(E. coli), Klebsiella pneumoniae(K. pneumoniae), Proteus mirabilis(P. mirabilis), and Klebsiella oxytoca. Whole genome sequencing analysis showed the clonal spread of K. pneumoniae carbapenemase(KPC)-2-producing K. pneumoniae sequence type(ST) 11 and New Delhi metallo-β-lactamase(NDM)-5-producing E. coli ST167 in our collection. Plasmid analysis revealed that carbapenemase-encoding genes were located on multiple plasmids. A high prevalence of biofilm-encoding type 3 fimbriae clusters and yesiniabactin-associated genes was observed in K. pneumoniae isolates. This work demonstrates the high prevalence of ESBLs and the wide dissemination of CPE among BSI isolates in China, which represent real clinical threats. Moreover, our findings first illustrate a more comprehensive genome scenario of CPE isolates among BSIs. The clonal spread of KPC-2-producing K. pneumoniae ST11 and NDM-5-producing E. coli ST167 needs to be closely monitored.

关键词： carbapenemase carbapenemase-producing Enterobacteriaceae Plasmid-mediated China Extended-spectrum b-lactamase

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