Clonal and Horizontal Transmission of blaNDM among Klebsiella pneumoniae in Children’s Intensive Care Units

• Published in: Microbiology spectrum 2022-06, Vol.10 (4), p.e0157421
• Main Authors: Fu, Bo, Yin, Dandan, Sun, Chengtao, Shen, Yingbo, Liu, Dejun, Bai, Rina, Zhang, Rong, Shen, Jianzhong, Hu, Fupin, Wang, Yang
• Format: Article
• Language: English
• Subjects: Bacteriology; Research Article
• ISSN: 2165-0497; 2165-0497
• DOI: 10.1128/spectrum.01574-21

Increasing infections caused by blaNDM-carrying Klebsiella pneumoniae (NDM-KP) are an urgent threat to children with weakened immunity and limited antibiotic use. Preventing and intervening in NDM-KP infections requires a clear understanding of the pathogen’s molecular and epidemiological characteristics. We investigated the prevalence and characteristics of NDM-KP in six children’s hospitals from five Chinese provinces/municipalities. We collected 111 NDM-KP strains (40 NDM-1, one NDM-4 and 70 NDM-5) from neonatal intensive care units (NICUs) and pediatric intensive care units (PICUs) from June 2017 to June 2018; these strains accounted for 31.62% of all carbapenem-resistant K. pneumoniae (CR-KP). Although NDM-KP isolates exhibited high resistance to all carbapenems, including ertapenem (MIC: ≥32 mg/L, 96.4%), imipenem (MIC: ≥16 mg/L, 90.1%) and meropenem (MIC: ≥16 mg/L, 99.1%), they were fully sensitive to amikacin, tigecycline and polymyxin B, and presented low resistance to levofloxacin (9.9%) and gentamicin (15.3%). Whole-genome sequencing was conducted to gain insight into the molecular characterizations of NDM-KP isolates. The NDM-KP isolates belonged to 20 sequence types (STs), and ST2407 (n = 45) dominated in one hospital from Chengdu. ST2407 isolates with fewer single-nucleotide polymorphisms (SNP