Molecular epidemiology of extensively drug-resistant Klebsiella pneumoniae outbreak in Wenzhou, Southern China.

In this study, we characterized the phenotypes and genetic features of nine XDR K. pneumoniae outbreak from a integrated hospital in Zhejiang province, China, during September 2014 to October 2014. These XDR K. pneumoniae possessed at least five resistance determinants, which contribute to highly resistance to -lactam, -lactam/inhibitor combinations, aminoglycosides, quinolones, carbapenems, chloroamphenicol and fosfomycin. All isolates carried blaKPC-2, blaCTX-M-9, blaSHV-11, rmtB and several isolates also harbored blaTEM-1 and qnrS. Southern blot experiments confirmed that blaKPC-2, rmtB, blaCTX-M-9 were located on the same ~54.2kb plasmid. Conjugative plasmids were obtained from all K. pneumoniae isolates, further proving the transferable characteristic of the resistance determinants. The OmpK36 sequences showed various deletions and insertions that were indicated to lead to additional amino acid residues and a deleted phenotype of OmpK36. Pulsed-field gel electrophoresis (PFGE) demonstrated that all the isolates belonged to the same genotype. Multilocus sequence typing (MLST) was concordant with PFGE results and revealed that ST11 was the most predominant clone. Our study revealed a high incidence and endemic spread of XDR K. pneumoniae in the hospital. Thus, effective infection control measures should be adopted to monitor and control the spread of the multidrug resistant isolates. PMID: 27542822 [PubMed - as supplied by publisher]
Source: Journal of Medical Microbiology - Category: Microbiology Authors: Tags: J Med Microbiol Source Type: research