机构：[1]Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan, China.[2]Faculty of Life Science and Technology, Kunming University of Science and Technology, No. 727 Jing Ming Road, Chenggong District, Kunming, Yunnan, China.[3]Department of Clinical Laboratory, First People’s Hospital of Yunnan province, Kunming, Yunnan, China.医技片检验科云南省第一人民医院[4]Department of Clinical Laboratory, Kunming City Maternal and Child health Hospital, Kunming, Yunnan, China.[5]Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China.
Background: In the past decade, the carbapenemase-producing Enterobacteriaceae (CPE) have been reported worldwide. Emergence of carbapenemase-producing strains among Enterobacteriaceae has been a challenge for treatment of clinical infection. The present study was undertaken to investigate the characteristics of carbapenem-resistant Klebsiella pneumoniae recovered from an outbreak that affected 17 neonatal patients in neonatal intensive care unit (NICU) of Kunming City Maternal and Child health Hospital, which is located in the Kunming city in far southwest of China. Methods: Minimum inhibitory concentrations (MICs) for antimicrobial agents were determined according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI); Modified Hodge test and Carba-NP test were preformed to identified the phenotypes of carbapenemases producing; To determine whether carbapenem resistance was transferable, a conjugation experiment was carried out in mixed broth cultures; Resistant genes were detected by using PCR and sequencing; Plasmids were typed by PCR-based replicon typing method; Clone relationships were analyzed by using multilocus-sequence typing (MLST) and pulsed field gel electrophoresis (PFGE). Results: Eighteen highly carbapenem-resistant Klebsiella pneumoniae were isolated from patients in NICU and one carbapenem-resistant K. pneumoniae isolate was detected in incubator water. All these isolates harbored bla(NDM-1). Moreover, other resistance genes, viz., bla(IMP-4), bla(SHV-1), bla(TEM-1), bla(CTX-M-15), qnrS1, qnrB4, and aacA4 were detected. The bla(NDM-1) gene was located on a ca. 50 kb IncFI type plasmid. PFGE analysis showed that NDM-1-producing K. pneumoniae were clonally related and MLST assigned them to sequence type 105. Conclusions: NDM-1 producing strains present in the hospital environment pose a potential risk and the incubator water may act as a diffusion reservoir of NDM-1-producing bacteria. Nosocomial surveillance system should play a more important role in the infection control to limit the spread of these pathogens.
基金：
This work was supported by Yunnan Science
and Technology Commission (2013FB205, 2015BC001) from Yunnan provincial
Science and Technology Department and Kunming Medical University.
第一作者机构：[1]Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan, China.[2]Faculty of Life Science and Technology, Kunming University of Science and Technology, No. 727 Jing Ming Road, Chenggong District, Kunming, Yunnan, China.[3]Department of Clinical Laboratory, First People’s Hospital of Yunnan province, Kunming, Yunnan, China.
共同第一作者：
通讯作者：
通讯机构：[1]Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, Yunnan, China.[2]Faculty of Life Science and Technology, Kunming University of Science and Technology, No. 727 Jing Ming Road, Chenggong District, Kunming, Yunnan, China.
推荐引用方式(GB/T 7714)：
Zheng Rui,Zhang Qian,Guo Yidan,et al.Outbreak of plasmid-mediated NDM-1-producing Klebsiella pneumoniae ST105 among neonatal patients in Yunnan, China[J].ANNALS OF CLINICAL MICROBIOLOGY AND ANTIMICROBIALS.2016,15:doi:10.1186/s12941-016-0124-6.
APA：
Zheng, Rui,Zhang, Qian,Guo, Yidan,Feng, Yue,Liu, Li...&Xia, Xueshan.(2016).Outbreak of plasmid-mediated NDM-1-producing Klebsiella pneumoniae ST105 among neonatal patients in Yunnan, China.ANNALS OF CLINICAL MICROBIOLOGY AND ANTIMICROBIALS,15,
MLA：
Zheng, Rui,et al."Outbreak of plasmid-mediated NDM-1-producing Klebsiella pneumoniae ST105 among neonatal patients in Yunnan, China".ANNALS OF CLINICAL MICROBIOLOGY AND ANTIMICROBIALS 15.(2016)
