Antimicrobial susceptibility and resistance genes of carbapenem-resistant Klebsiella pneumoniae in China from 2017 to 2018

Abstract:

Objective To analyze antimicrobial susceptibility and carrying status of antimicrobial resistance genes of carbapenem-resistant Klebsiella pneumoniae (CRKP) in China. Methods Antimicrobial susceptibility testing was performed on CRKP collected from the China Antimicrobial Resistance Surveillance Trial from 2017 to 2018 by Institute of Clinical Pharmacology of Peking University, carrying status of carbapenemase genes and other extended-spectrum beta-lactamases (ESBLs) genes in CRKP were detected by polymerase chain reaction (PCR) and sequencing detection. Results A total of 129 strains of CRKP were screened out, polymyxin E, tigecycline, fosfomycin trometamol and minocycline were the effective antimicrobial agents, susceptibility rates were 80.62%, 79.07%, 51.16% and 51.16% respectively, susceptibility rates of other antimicrobial agents were all lower than 46%. PCR and sequencing results showed that 112 strains carried carbapenemase gene, mainly bla_KPC-2 (77.52%) and bla_NDM (8.53%) genes, and 3 strains (2.33%) carried both bla_KPC-2 and bla_NDM genes. Detection rate of bla_TEM gene was 51.94% (67/129), all of which were bla_TEM-1; detection rate of bla_SHV gene was 64.34% (83/129), mainly bla_SHV-12 gene (27.91%, 36/129); detection rate of bla_CTX-M gene was 53.49% (69/129), which were bla_CTX-M-9 (43.41%) and bla_CTX-M-15 (10.08%) respectively, 4 strains (3.10%) contained both bla_CTX-M-9 and bla_CTX-M-15 genes. Among carbapenemase gene positive strains, 80.36% (90/112) carried ESBLs genes simultaneously, and 32.14% (36/112) carried two or more ESBLs genes simultaneously. Conclusion Antimicrobial resistance of CRKP isolated in China is serious, and there are multiple antimicrobial resistance genes at the same time, the most common carbapenemase gene is bla_KPC-2 gene, and the most common ESBLs genes are bla_SHV-12 and bla_CTX-M-9 genes.