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Genotypic Distribution and Antimicrobial Susceptibilities of Carbapenemase-Producing Enterobacteriaceae Isolated From Rectal and Clinical Samples in Korean University Hospitals Between 2016 and 2019

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Background: The emergence of carbapenemase-producing Enterobacteriaceae (CPE) represents a major clinical problem. Recently, the occurrence of CPE has increased globally, but epidemiological patterns vary across region. We report the trends in the genotypic distribution and antimicrobial susceptibility of CPE isolated from rectal and clinical samples during a four-year period. Methods: Between January 2016 and December 2019, 1,254 nonduplicated CPE isolates were obtained from four university hospitals in Korea. Carbapenemase genotypes were determined by multiplex real-time PCR. Antimicrobial susceptibility was profiled using the Vitek 2 system (bioMérieux, Hazelwood, MO, USA) or MicroScan Walkaway-96 system (Siemens West Sacramento, CA, USA). The proportions of carbapenemase genotypes and nonsusceptibility were analyzed using Pearson’s chi-square test. Results: Among the 1,254 CPE isolates, 486 (38.8%), 371 (29.6%), 357 (28.5%), 8 (0.6%), 8 (0.6%), and 24 (1.9%) were Klebsiella pneumoniae carbapenemase (KPC), oxacillinase (OXA)-48-like, New Delhi metallo-β-lactamase (NDM), imipenemase (IMP), Verona integron-encoded metallo-β-lactamase (VIM), and multiple producers, respectively. The predominant species was K. pneumoniae (72.6%), followed by Escherichia coli (6.5%). More than 90% of the isolates harboring KPC, NDM, and OXA-48-like were nonsusceptible to cephalosporins, aztreonam, and carbapenems. Conclusions: The impact of CPE is primarily due to KPC-, NDM-, and OXA-48-like-producing K. pneumoniae isolates. Isolates carrying these carbapenemase are mostly multidrug-resistant. Control strategies based on these genotypic distributions and antimicrobial susceptibilities of CPE isolates are required.

Abstract

Background: The emergence of carbapenemase-producing Enterobacteriaceae (CPE) represents a major clinical problem. Recently, the occurrence of CPE has increased globally, but epidemiological patterns vary across region. We report the trends in the genotypic distribution and antimicrobial susceptibility of CPE isolated from rectal and clinical samples during a four-year period. Methods: Between January 2016 and December 2019, 1,254 nonduplicated CPE isolates were obtained from four university hospitals in Korea. Carbapenemase genotypes were determined by multiplex real-time PCR. Antimicrobial susceptibility was profiled using the Vitek 2 system (bioMérieux, Hazelwood, MO, USA) or MicroScan Walkaway-96 system (Siemens West Sacramento, CA, USA). The proportions of carbapenemase genotypes and nonsusceptibility were analyzed using Pearson’s chi-square test. Results: Among the 1,254 CPE isolates, 486 (38.8%), 371 (29.6%), 357 (28.5%), 8 (0.6%), 8 (0.6%), and 24 (1.9%) were Klebsiella pneumoniae carbapenemase (KPC), oxacillinase (OXA)-48-like, New Delhi metallo-β-lactamase (NDM), imipenemase (IMP), Verona integron-encoded metallo-β-lactamase (VIM), and multiple producers, respectively. The predominant species was K. pneumoniae (72.6%), followed by Escherichia coli (6.5%). More than 90% of the isolates harboring KPC, NDM, and OXA-48-like were nonsusceptible to cephalosporins, aztreonam, and carbapenems. Conclusions: The impact of CPE is primarily due to KPC-, NDM-, and OXA-48-like-producing K. pneumoniae isolates. Isolates carrying these carbapenemase are mostly multidrug-resistant. Control strategies based on these genotypic distributions and antimicrobial susceptibilities of CPE isolates are required.

참고문헌 (33)

  1. Doi Y, "Carbapenemase-producing Enterobacteriaceae", Semin Respir Crit Care Med, 36, pp.74~84 (2015)
  2. Nordmann P, "Carbapenemase-producing Enterobacteriaceae : overview of a major public health challenge", Med Mal Infect, 44, pp.51~56 (2014)
  3. Walsh C, "Molecular mechanisms that confer antibacterial drug resistance", Nature, 406, pp.775~781 (2000)
  4. Lee Miyoung, "Antimicrobial Resistance Caused by KPC-2 Encoded by Promiscuous Plasmids of the Klebsiella pneumoniae ST307 Strain", Annals of Laboratory Medicine, 41(1), pp.86~94 (2021), 대한진단검사의학회[DOI]
  5. Yigit H, "Novel carbapenem-hydrolyzing beta-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae", Antimicrob Agents Chemother, 45, pp.1151~1161 (2001)
  6. Yong D, "Characterization of a new metallo-beta-lactamase gene, bla(NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India", Antimicrob Agents Chemother, 53, pp.5046~5054 (2009)
  7. Nordmann P, "Global spread of carbapenemase-producing Enterobacteriaceae", Emerg Infect Dis, 17, pp.1791~1798 (2011)
  8. Poirel L, "Emergence of oxacillinase-mediated resistance to imipenem in Klebsiella pneumoniae", Antimicrob Agents Chemother, 48, pp.15~22 (2004)
  9. 정석훈, "Prevalence and Molecular Characteristics of Carbapenemase-Producing Enterobacteriaceae From Five Hospitals in Korea", Annals of Laboratory Medicine, 36(6), pp.529~535 (2016), 대한진단검사의학회
  10. Lee H, "Antimicrobial resistance of major clinical pathogens in South Korea, May 2016 to April 2017: first one-year report from Kor-GLASS", Euro Surveill, 23, pp.1800047~ (2018)
  11. 송원근, "Combined Use of the Modified Hodge Test and Carbapenemase Inhibition Test for Detection of Carbapenemase-Producing Enterobacteriaceae and Metallo-β-Lactamase-Producing Pseudomonas spp.", Annals of Laboratory Medicine, 35(2), pp.212~219 (2015), 대한진단검사의학회
  12. Jeong S, "Evaluation of peptide nucleic acid-mediated multiplex real-time PCR kits for rapid detection of carbapenemase genes in gram-negative clinical isolates", J Microbiol Methods, 113, pp.4~9 (2015)
  13. CLSI, "Performance standards for antimicrobial susceptibility testing" (2016), Clinical and Laboratory Standards Institute
  14. "Clinical breakpoints - breakpoints and guidance" (2021)[URL]
  15. 송원근, "Rapid Identification of OXA-48-like, KPC, NDM, and VIM Carbapenemase-Producing Enterobacteriaceae From Culture: Evaluation of the RESIST-4 O.K.N.V. Multiplex Lateral Flow Assay", Annals of Laboratory Medicine, 40(3), pp.259~263 (2020), 대한진단검사의학회[DOI]
  16. Nordmann P, "The difficult-to-control spread of carbapenemase producers among Enterobacteriaceae worldwide", Clin Microbiol Infect, 20, pp.821~830 (2014)
  17. Rhee JY, "KPC-producing extreme drug-resistant Klebsiella pneumoniae isolate from a patient with diabetes mellitus and chronic renal failure on hemodialysis in South Korea", Antimicrob Agents Chemother, 54, pp.2278~2279 (2010)
  18. Hong SK, "First outbreak of KPC-2-producing Klebsiella pneumoniae sequence type 258 in a hospital in South Korea", J Clin Microbiol, 51, pp.3877~3879 (2013)
  19. Kim MN, "Nosocomial clustering of NDM-1-producing Klebsiella pneumoniae sequence type 340 strains in four patients at a South Korean tertiary care hospital", J Clin Microbiol, 50, pp.1433~1436 (2012)
  20. Yoo JS, "Nosocomial transmission of NDM-1-producing Escherichia coli ST101 in a Korean hospital", J Antimicrob Chemother, 68, pp.2170~2172 (2013)
  21. Sekirov I, "Epidemiologic and genotypic review of carbapenemase-producing organisms in British Columbia, Canada, between 2008 and 2014", J Clin Microbiol, 54, pp.317~327 (2016)
  22. Jeong SH, "Clonal and horizontal spread of the blaOXA-232 gene among Enterobacteriaceae in a Korean hospital", Diagn Microbiol Infect Dis, 82, pp.70~72 (2015)
  23. Poirel L, "OXA-48-like carbapenemases : the phantom menace", J Antimicrob Chemother, 67, pp.1597~1606 (2012)
  24. Walsh TR, "Emerging carbapenemases : a global perspective", Int J Antimicrob Agents, 36, pp.S8~S14 (2010)
  25. 이진영, "Outbreak of Imipenemase-1-Producing Carbapenem-Resistant Klebsiella pneumoniae in an Intensive Care Unit", Acute and Critical Care, 32(1), pp.29~38 (2017), 대한중환자의학회
  26. Lauretti L, "Cloning and characterization of blaVIM, a new integron-borne metallo-beta-lactamase gene from a Pseudomonas aeruginosa clinical isolate", Antimicrob Agents Chemother, 43, pp.1584~1590 (1999)
  27. 홍덕진, "Epidemiology and Characteristics of Metallo-β-Lactamase-Producing Pseudomonas aeruginosa", Infection and Chemotherapy, 47(2), pp.81~97 (2015), 대한감염학회[DOI]
  28. Tseng IL, "Emergence of carbapenemase producing Klebsiella pneumonia and spread of KPC-2 and KPC-17 in Taiwan : A nationwide study from 2011 to 2013", PLoS One, 10, pp.e0138471~ (2015)
  29. Endimiani A, "Cefepime : a reappraisal in an era of increasing antimicrobial resistance", Expert Rev Anti Infect Ther, 6, pp.805~824 (2008)
  30. Sader HS, "Potency and spectrum trends for cefepime tested against 65746 clinical bacterial isolates collected in North American medical centers : results from the SENTRY Antimicrobial Surveillance Program(1998-2003)", Diagn Microbiol Infect Dis, 52, pp.265~273 (2005)
  31. Ji S, "Cefepime combined with amoxicillin", clavulanic acid: a new choice for the KPC-producing K. pneumoniae infection, 2015, pp.38, 108~114
  32. Bartolini A, "Prevalence, molecular epidemiology and intra-hospital acquisition of Klebsiella pneumoniae strains producing carbapenemases in an Italian teaching hospital from January 2015 to September 2016", Int J Infect Dis, 59, pp.103~109 (2017)
  33. Fuster B, "Detection of two simultaneous outbreaks of Klebsiella pneumoniae coproducing OXA-48 and NDM-1 carbapenemases in a tertiary-care hospital in Valencia, Spain", New Microbes New Infect, 34, pp.100660~ (2020)

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