Genomic and Phenotypic Diversity of Carbapenemase-Producing Enterobacteriaceae Isolates from Bacteremia in China: A Multicenter Epidemiological, Microbiological, and Genetic Study  

作　　者：Beiwen Zheng Hao Xu Lihua Guo Xiao Yu Jinru Ji Chaoqun Ying Yunbo Chen Ping Shen Huiming Han Chen Huang Shuntian Zhang Tao Lv Yonghong Xiao 

机构地区：[1]State Key Laboratory for Diagnosis and Treatment of Infectious Diseases,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases,The First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,China [2]Medical College of Beihua University,Jilin 132013,China [3]Department of Infectious Diseases,Ningbo Medical Center Li Huili Hospital,Ningbo 315040,China

出　　处：《Engineering》2022年第5期90-100,共11页工程（英文）

基　　金：the financial support of the National Key Research and Development Program of China (2017YFC1200203 and 2016YFD0501105);the Mega-projects of Science Research of China (2018ZX10733402-004 and 2018ZX10712001-005);the National Natural Science Foundation of China (81741098 and 81711530049);the Zhejiang Provincial Key Research and Development Program (2015C03032);the Zhejiang Provincial Natural Science Foundation of China (LY17H190003)

摘　　要：Carbapenemase-producing Enterobacteriaceae(CPE) isolates are recognized as one of the most severe threats to public health. However, the population structure and genetic characteristics of CPE isolates among bloodstream infections(BSIs) are largely unknown. To address this knowledge gap, in this study,we included patients with clinically significant BSIs due to Enterobacterales isolates, recruited from 26 sentinel hospitals in China(2014–2015). CPE isolates were microbiologically and genomically characterized,including their susceptibility profiles, molecular typing, phylogenetic features, and genetic context analysis of carbapenemase-encoding genes. Of the 2569 BSI Enterobacterales isolates enrolled, 42(1.6%) were carbapenemase-positive. Moreover, among the 2242 investigated isolates, 1111(49.6%) extendedspectrum β-lactamase(ESBL)-producing isolates were identified in Escherichia coli(E. coli), Klebsiella pneumoniae(K. pneumoniae), Proteus mirabilis(P. mirabilis), and Klebsiella oxytoca. Whole genome sequencing analysis showed the clonal spread of K. pneumoniae carbapenemase(KPC)-2-producing K. pneumoniae sequence type(ST) 11 and New Delhi metallo-β-lactamase(NDM)-5-producing E. coli ST167 in our collection. Plasmid analysis revealed that carbapenemase-encoding genes were located on multiple plasmids. A high prevalence of biofilm-encoding type 3 fimbriae clusters and yesiniabactin-associated genes was observed in K. pneumoniae isolates. This work demonstrates the high prevalence of ESBLs and the wide dissemination of CPE among BSI isolates in China, which represent real clinical threats. Moreover, our findings first illustrate a more comprehensive genome scenario of CPE isolates among BSIs. The clonal spread of KPC-2-producing K. pneumoniae ST11 and NDM-5-producing E. coli ST167 needs to be closely monitored.

关 键 词：CARBAPENEMASE Carbapenemase-producing ENTEROBACTERIACEAE PLASMID-MEDIATED China Extended-spectrum b-lactamase 

分 类 号：R515.3[医药卫生—内科学]