Characterization of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae from a healthcare region in Hong Kong
- 6 January 2016
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Journal of Clinical Microbiology & Infectious Diseases
- Vol. 35 (3), 379-385
- https://doi.org/10.1007/s10096-015-2550-3
Abstract
Carbapenem-resistant Enterobacteriaceae represents a major public health issue. This study investigated the clonality and resistance mechanisms of 92 carbapenem-resistant E. coli (n = 21) and K. pneumoniae (n = 71) isolates collected consecutively from clinical specimens and patients at high risk of carriage between 2010 and 2012 in a healthcare region in Hong Kong. Combined disk tests (CDTs) and the Carba NP test were used for phenotypic detection of carbapenemases. PCR assays were used to detect carbapenemase genes. All isolates were intermediate or resistant to at least one carbapenem. Nine (9.8 %) isolates were genotypic carbapenemase producers and included six K. pneumoniae (one ST1306/bla IMP-4, one ST889/bla IMP-4, two ST11/bla KPC-2, one ST258/bla KPC-2, one ST483/bla NDM-1) and three E. coli (one ST131/bla IMP-4, two ST744/ bla NDM-1) isolates. All nine isolates carrying carbapenemase genes could be detected by the CDTs and the Carba NP test. PCR identified bla CTX-M and bla AmpC alone or in combination in 77.8 % (7/9) and 96.4 % (80/83) of the carbapenemase-producers and non-producers, respectively. Porin loss was detected in 22.2 % (2/9) and 59.0 % (49/83) of the carbapenemase-producers and non-producers, respectively. Overall, the E. coli clones were diverse (14 different STs), but 36.6 % (26/71) of the K. pneumoniae isolates belonged to ST11. In conclusion, the prevalence of carbapenemases among carbapenem-nonsusceptible E. coli and K. pneumoniae remained low in Hong Kong. Porin loss combined with AmpC and/or CTX-M type ESBL was the major mechanism of carbapenem resistance in the study population.Keywords
Funding Information
- RGC Collaborative Research Fund Project on Syndromic Surveillance and Modelling for Infectious Diseases (CityU8/CRF/12G)
- Health and Medical Research Fund of the Food and Health Bureau of the Government of the HKSAR (HKM-15-M10)
This publication has 31 references indexed in Scilit:
- Performance of the CLSI Carba NP and the Rosco Carb Screen Assays Using North American Carbapenemase-Producing Enterobacteriaceae and Pseudomonas aeruginosa IsolatesJournal of Clinical Microbiology, 2015
- Review of established and innovative detection methods for carbapenemase-producing Gram-negative bacteriaJournal of Applied Microbiology, 2015
- The Role of Epidemic Resistance Plasmids and International High-Risk Clones in the Spread of Multidrug-Resistant EnterobacteriaceaeClinical Microbiology Reviews, 2015
- MALDI-TOF MS detection of carbapenemase activity in clinical isolates of Enterobacteriaceae spp., Pseudomonas aeruginosa, and Acinetobacter baumannii compared against the Carba-NP assayJournal of Microbiological Methods, 2015
- High prevalence of Escherichia coli sequence type 131 among antimicrobial-resistant E. coli isolates from geriatric patientsJournal of Medical Microbiology, 2015
- Evaluation of Carbapenemase Screening and Confirmation Tests with Enterobacteriaceae and Development of a Practical Diagnostic AlgorithmJournal of Clinical Microbiology, 2015
- The Clermont Escherichia coli phylo‐typing method revisited: improvement of specificity and detection of new phylo‐groupsEnvironmental Microbiology Reports, 2012
- Carbapenemases in Klebsiella pneumoniae and Other Enterobacteriaceae: an Evolving Crisis of Global DimensionsClinical Microbiology Reviews, 2012
- Complete Sequencing of pNDM-HK Encoding NDM-1 Carbapenemase from a Multidrug-Resistant Escherichia coli Strain Isolated in Hong KongPLOS ONE, 2011
- Detection of Plasmid-Mediated AmpC β-Lactamase Genes in Clinical Isolates by Using Multiplex PCRJournal of Clinical Microbiology, 2002