Drug Susceptibility and Molecular Epidemiology of Klebsiella pneumoniae Bloodstream Infection in ICU Patients in Shanghai, China

Shuzhen Xiao; Tianchi Chen; Hairu Wang; Qian Zeng; Qing Chen; Zhitao Yang; Lizhong Han; Erzhen Chen

doi:10.3389/fmed.2021.754944

Drug Susceptibility and Molecular Epidemiology of Klebsiella pneumoniae Bloodstream Infection in ICU Patients in Shanghai, China

Front Med (Lausanne). 2021 Oct 13:8:754944. doi: 10.3389/fmed.2021.754944. eCollection 2021.

Authors

Shuzhen Xiao^{1

2}, Tianchi Chen³, Hairu Wang⁴, Qian Zeng^{1

2}, Qing Chen^{1

2}, Zhitao Yang⁵, Lizhong Han^{1

2}, Erzhen Chen⁵

Affiliations

¹ Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ Department of Laboratory Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁴ Departments of Clinical Laboratory, Shanxi Provincial People's Hospital, Affiliated of Shanxi Medical University, Taiyuan, China.
⁵ Emergency Department, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Abstract

Background: Bloodstream infections (BSIs) are recognized as important nosocomial infections. Klebsiella pneumoniae is one of the major causes of bacteremia. This retrospective study focused on drug susceptibility and molecular epidemiology of K. pneumoniae isolated from intensive care unit (ICU) patients with BSI in Shanghai, China. Methods: Consecutive K. pneumoniae isolates were collected from ICU patients. Antibiotic susceptibility testing was conducted by the broth microdilution method. PCR was performed to detect antimicrobial resistance genes. We also completed multilocus sequence typing (MLST) and GoeBURST was used to analyze the result of MLST. Results: A total of 78 K. pneumoniae isolates were enrolled. K. pneumoniae from ICU-BSIs were highly resistant to almost all common antibiotics. The most frequent resistance determinants responsible for extended-spectrum β-lactamase (ESBL) producers were bla _CTX-M-14, bla _CTX-M-15, and bla _CTX-M-55. KPC was the only enzyme, which was detected by the carbapenemase producers. The most principal sequence types (STs) were ST11, ST15, and ST23. Conclusion: This study presents for the first time the antibiotic resistance phenotype and molecular epidemiology of K. pneumoniae isolated from ICU patients with BSIs in Shanghai. ICU-BSI K. pneumoniae is characteristic of a high resistance rate. The occurrence of the KPC-2 enzyme may result from nosocomial clonal dissemination of ST11 K. pneumoniae.

Keywords: Klebsiella pneumoniae; bloodstream infection; drug susceptibility; intensive care units; molecular epidemiology.