Outbreak of KPC-2 Carbapenem-resistant Klebsiella pneumoniae ST76 and Carbapenem-resistant K2 Hypervirulent Klebsiella pneumoniae ST375 strains in Northeast China: molecular and virulent characteristics

Su, Shanshan; Zhang, Jisheng; Zhao, Yongxin; Yu, Lan; Wang, Yong; Wang, Yuchao; Bao, Mingjia; Fu, Yu; Li, Chunjiang; Zhang, Xiaoli

doi:10.1186/s12879-020-05143-y

Table 1 Clinical characteristics, drug resistance genes and virulence-associated genes of 44 CRKP isolates

From: Outbreak of KPC-2 Carbapenem-resistant Klebsiella pneumoniae ST76 and Carbapenem-resistant K2 Hypervirulent Klebsiella pneumoniae ST375 strains in Northeast China: molecular and virulent characteristics

Isolate no.	Age (yr)	Date of specimen collection (yr/mo/day)	Isolation site(s)	Ward	Underlying disease	Treatment	Outcome	Resistance genes	Virulence genes	MLST
JmsCRE01	45–50	2015/3./11	Sputum	ICU	Brain and abdominal injury, pneumonia	Cefmenoxime, ETP, IMP, SCF, LVX	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE02	55–60	2016/12/29	Sputum	Neurosurgery	Brain injury, bacteremia, pneumonia	TZP, CRO, LZD, LVX	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE03	75–80	2016/11/21	Sputum	ICU	Lung cancer, cerebral hemorrhage, pneumonia	TZP, IMP, SCF, LVX	Died	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE04	55–60	2016/6/18	Sputum	Neurosurgery	Cerebral hemorrhage, pneumonia	TZP, LVX	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE05	65–70	2016/8/2	Sputum	Neurosurgery	Brain injury, cerebral hemorrhage, pneumonia	TZP, LVX, Cefoselis	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE06	65–70	2017/1/13	Sputum	Hematology	Cerebral hemorrhage, pneumonia, hypertension	TZP	Died	KPC-2, SHV	uge, mrkD, fimH, kpn	323
JmsCRE07	15–20	2016/8/22	Sputum	Emergency department	Brain injury, hemorrhagic shock, pleural effusion, pneumonia	Cefoperazone/tazobactam, IMP	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE08	70–75	2016/11/9	Sputum	Neurosurgery	Cerebral hemorrhage, hypertension, pneumonia, pleural effusion	TZP, CTT, MXF	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE09	85–90	2016/8/22	Sputum	ICU	Intestinal obstruction, liver abscess, lung space, pneumonia	Cefoperazone/tazobactam, IMP	Died	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE10	75–80	2016/11/2	Sputum	ICU	Cerebral hemorrhage, pneumonia	–	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE11	60–65	2016/11/2	Sputum	Neurosurgery	Cerebral hemorrhage, pneumonia, hypertension	TZP, SCF	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE12	75–80	2016/8/29	Sputum	ICU	Cerebral infarction, pericardial effusion, pneumonia	Cefoperazone/tazobactam, VAN, LVX	Died	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE14	60–65	2016/11/14	Sputum	Neurosurgery	Cerebral hemorrhage	TZ, LVX	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE15	30–35	2016/11/9	Sputum	Orthopedics	Cervical fracture, pneumonia	CLI, TZP, IMP, SCF, LVX	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE16	55–60	2016/6/8	Sputum	ICU	Cerebral hemorrhage, pleural effusion, pneumonia	CTT, LVX	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE17	80–85	2016/9/8	Sputum	ICU	Infectious shock, pneumonia	TZP, IMP, MXF	Died	KPC-2, SHV, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE18	40–45	2016/4/11	Sputum	ICU	Brain palsy, brain injury	TZP, LVX	Died	KPC-2, SHV, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE20	55–60	2016/5/10	Sputum	Neurosurgery	Aneurysm, cerebral hemorrhage	TZP, Ceftezole	Died	KPC-2, SHV, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE22	55–60	2017/2/5	Sputum	Emergency department	Gastric cancer, pneumonia	CMZ, TZP, SCF, MXF	Died	IMP-4, SHV, TEM	uge, mrkD, fimH, kpn	896
JmsCRE23	55–60	2016/8/22	Blood	ICU	Brain injury, cerebral hemorrhage, peritoneal effusion,	TZP, SCF, IMP	NR	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE24	65–70	2016/7/27	Blood	Neurosurgery	Cerebral hemorrhage, bacteremia, pneumonia, diabetes	CMZ, TZP, AMK, SCF	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE28	25–30	2016/10/25	Blood	ICU	Abdominal closure injury, spleen rupture, peritoneal effusion	TZP, IMP	Died	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE29	40–45	2016/8/12	Sputum	Neurosurgery	Cerebral hemorrhage, pneumonia	CMZ, TZP	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE30	65–70	2016/7/28	Sputum	ICU	Hydronephrosis, bacteremia, pneumonia	LVX, MXF, IMP, SCF, MSU	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE31	55–60	2016/5/27	Sputum	Neurosurgery	Brain abscess, pneumonia	Cefoselis, LVX	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge	76
JmsCRE32	35–40	2015/10/30	Sputum	Neurosurgery	Brain injury	TZP, LVX	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE34	60–65	2016/7/14	Sputum	ICU	Renal failure, uremia, cerebral infarction, pneumonia, pleural effusion	TZP	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE35	70–75	2016/7/22	Sputum	Neurosurgery	Cerebral hemorrhage, cerebral infarction, pneumonia	TZP, MXF	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE36	70–75	2016/8/28	Wound	ICU	Lower extremity crush sleeve, femoral shaft fracture	TZP, SCF, LVX	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE37	55–60	2015/12/23	Sputum	Hematology	Myelodysplastic syndrome, bacteremia	MEM, TZP	Died	IMP-4, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	2964
JmsCRE39	70–75	2016/11/30	Sputum	Neurosurgery	Cerebral infarction, coronary heart disease, pneumonia, Intracranial infection	TZP, FOX	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE44	65–70	2016/4/29	Sputum	Neurosurgery	Intracranial occupying lesions, pneumonia	CFZ, TZP	Died	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE47	55–60	2016/9/30	Blood	Hematology	Aplastic anemia, bacteremia	FOX, Cefoperazone/tazobactam, MXF, MEM	Recovered	KPC-2, SHV	uge, mrkD, fimH, kpn	11
JmsCRE48	75–80	2017/4/28	Sputum	Neurosurgery	Brain palsy, Cerebral hemorrhage, pneumonia	Ceftezole, TZP, MXF	Died	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE49	55–60	2017/6/7	Blood	Cardiac surgery	Brain injury, cerebral hemorrhage, pneumonia, bacteremia	TZP, SCF, Etimicin, FOF, IMP, LVX, AMK	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE50	75–80	2017/4/14	Sputum	Neurosurgery	Cerebral infarction, pneumonia, hypertension	TZP, FEP, LVX, IMP, SCF, MXF	Recovered	KPC-2, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE52	45–50	2016/10/6	Sputum	ICU	Brain injury, intracranial infection	ATM, CRO, Cefoselis, LZD	Recovered	KPC-2, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE54	65–70	2016/4/6	Sputum	Neurosurgery	Cerebral infarction, urinary tract infection, pneumonia	TZP, MXF	Recovered	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE55	55–60	2017/4/7	Sputum	ICU	Cerebral hemorrhage, pneumonia	TZP, MEM	NR	KPC-2, SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE56	60–65	2017/9/3	Sputum	Neurosurgery	Cerebral hemorrhage, pneumonia, bronchiectasis	TZP	Recovered	SHV, TEM, CTX-M-15	uge, mrkD, fimH, kpn	76
JmsCRE57	70–75	2017/11/8	Sputum	ICU	Subarachnoid hemorrhage, cerebral aneurysm, hypostatic pneumonia, hypertension, arrhythmia	Cefoselis, CRO, FOF, Etimicin	Recovered	KPC-2, SHV, DHA, TEM, CTX-M-15	uge, mrkD, fimH, kpn, aero, rmpA	375
JmsCRE58	40–45	2017/10/14	Sputum	ICU	Brain injury, subarachnoid hemorrhage, skull fracture, chest closure injury, rib fracture	TZP, LVX, Etimicin, VRC	Recovered	IMP-4, SHV, TEM	uge, mrkD, fimH, kpn	76
JmsCRE59	55–60	2018/1/16	Sputum	Emergency department	Cerebral infarction, pneumonia, hypertension	CMZ, Etimicin	Recovered	NDM, TEM, CTX-M-15	uge, mrkD, fimH, kpn	530
JmsCRE62	35–40	2017/12/13	Sputum	Emergency department	Diabetes ketoacidosis, ion disorder, urinary tract infection, pneumonia, hypoproteinemia, anemia	Cefoperazone/tazobactam, Etimicin	Recovered	KPC-2, SHV, DHA, TEM, CTX-M-15	uge, mrkD, fimH, kpn, alls	3335

Note: ICU Intensive Care Unit, ETP ertapenem, IMP imipenem, SCF cefoperazone/sulbactam, LVX levofloxacin, TZP piperacillin/tazobactam, CRO ceftriaxone, LZD linezolid, CTT cefotetan, MXF moxifloxacin, VAN vancomycin, CLI clindamycin, CMZ cefmetazole, AMK amikacin, MSU mezlocillin/sulbactam, CFZ cefazolin, FOX cefoxitin, MEM meropenem, FOF fosfomycin, FEP cefepime, ATM aztreonam, VRC voriconazole; −,unmedicated, NR no record, MLST multilocus sequence typing. Resistance and virulence genes were amplified by PCR.

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ISSN: 1471-2334

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