A comparative study of genotyping and antimicrobial resistance between carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii isolates at a tertiary pediatric hospital in China

Front Cell Infect Microbiol. 2024 Mar 8:14:1298202. doi: 10.3389/fcimb.2024.1298202. eCollection 2024.

Abstract

Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) clinical isolations have rapidly increased in pediatric patients. To investigate a possible health care-associated infections of CRKP in a tertiary pediatric hospital, the circulating clones and carbapenem-resistant pattern between CRKP and carbapenem-resistant Acinetobacter baumannii (CRAB) isolates were compared to classify their epidemiological characteristics. The results will help to identify the epidemic pattern of the CRKP transmission in the hospital.

Methods: Ninety-six CRKP and forty-eight CRAB isolates were collected in Kunming Children's Hospital from 2019 through 2022. These isolates were genotyped using repetitive extragenic palindromic-PCR (REP-PCR). Carbapenemase phenotypic and genetic characterization were investigated using a disk diffusion test and singleplex PCR, respectively. In addition, these characteristics of the two pathogens were compared.

Results: The rates of CRKP and CRAB ranged from 15.8% to 37.0% at the hospital. Forty-nine and sixteen REP genotypes were identified among the 96 and 48 CRKP and CRAB isolates tested, respectively. The CRKP isolates showed more genetic diversity than the CRAB isolates. Of the 96 CRKP isolates, 69 (72%) produced Class B carbapenemases. However, all 48 CRAB isolates produced Class D carbapenemase or extended-spectrum β-lactamases (ESBL) combined with the downregulation of membrane pore proteins. Furthermore, the carbapenemase genes bla KPC, bla IMP, and bla NDM were detected in CRKP isolates. However, CRAB isolates were all positive for the bla VIM, bla OXA-23, and bla OXA-51 genes.

Conclusions: These CRKP isolates exhibited different biological and genetic characteristics with dynamic changes, suggesting widespread communities. Continuous epidemiological surveillance and multicenter research should be carried out to strengthen the prevention and control of infections.

Keywords: REP-PCR; carbapenem-resistant Acinetobacter baumannii; carbapenem-resistant Klebsiella pneumoniae; carbapenemase; pediatric patient.

Publication types

  • Multicenter Study

MeSH terms

  • Acinetobacter baumannii*
  • Anti-Bacterial Agents / pharmacology
  • Carbapenem-Resistant Enterobacteriaceae*
  • Carbapenems / pharmacology
  • Child
  • Drug Resistance, Bacterial
  • Genotype
  • Hospitals, Pediatric
  • Humans
  • Klebsiella pneumoniae
  • Microbial Sensitivity Tests
  • beta-Lactamases / genetics
  • beta-Lactamases / metabolism

Substances

  • Anti-Bacterial Agents
  • beta-Lactamases
  • Carbapenems

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research received the grants from the High-Quality Professional Youth Introduction Project of Kunming City when performing data analysis, manuscript writing, and interpretation of data, and the Health Research Project of Kunming Health Commission (2021-06-01-0010 and 2022-11-01-009), the Talent Training Program of Kunming Health Commission (2022-SW [Houbei]-50) and the Kunming Medical University Union Special Fund (202301AY070001-172) when performing study design.