Diverse genetic characteristics of ESBL-producing Klebsiella pneumoniae isolates from obstetrics & gynaecology settings in some major hospitals, China

Abstract

Diverse genetic characteristics of ESBL-producing Klebsiella pneumoniae isolates from obstetrics & gynaecology settings in some major hospitals, China Xiao-Mei Zhang1 , He Wang2 , Ming-Cheng Li2, * ,† , Xue-Ying Bao1,† , Jia-Yu Chen3,† 1Department of Clinical Laboratory, Associated Hospital, Beihua University, 132002 Jilin, Jilin, China 2Department of Molecular Diagnosis, School of Laboratory Medicine, Beihua University, 132013 Jilin, Jilin, China 3Department of Clinical Laboratory, Shaoxing University, 321000 Shaoxing, Zhejing, China *Correspondence: limingcheng@beihua.edu.cn; baoxueying@beihua.edu.cn (Ming-Cheng Li) † These authors contributed equally. DOI:10.31083/j.ceog.2021.03.2259 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: 19 August 2020 Revised: 8 October 2020 Accepted: 21 October 2020 Published: 15 June 2021 Background: We investigated the susceptibility patterns and genotype of extended-spectrum-beta-lactamase (ESBL)-producing Klebsiella pneumoniae isolates. Methods: A prospective survey of K. pneumoniae-infected patients was conducted in obstetrics & gynaecology settings in three associated hospitals of a university in China from 2017 to 2019. All isolates were identified as K. pneumoniae by the conventional standard procedures and confirmed by use of the VITEK GNI system. Susceptibility to 16 antimicrobial agents of ESBLs was determined by way of a screening procedure using discs. PCR amplification of bla genes, and sequencing of PCR products were performed to determine their molecular types. Results: A total of 518 of K. pneumoniae were isolated from sputum specimens in three affiliated hospitals. Out of these, 158 strains were ESBL producers and 64 strains were non-ESBL producers from the first hospital; 114 strains were positive for producing ESBLs and 60 strains were negative for ESBLs in the second hospital, and 86 strains were ESBL producer and 36 strains were negative from the third hospital. bla gene contents showed that 88 strains (24.6%) carried the blaT EM−2 gene, and 74 strains (20.1%) contained the blaSHV −3 gene, 44 strains (12.3%) had the blaCTX−M−2 gene, 42 strains (11.7%) had the blaCTX−M−4 gene, 38 strains (10.6%) harboured blaCTX−M−5 and blaCTX−M−8 genes, and 29 (9.5%) strains contained blaCTX−M−15 gene. Also, 20 (5.6%) strains contained blaOXA−1. The co-existence of blaCTX−M−15 and blaSHV −3 was identified in 20 strains (5.6%), 12 strains (3.3%) co-existed with blaSHV −3 and blaT EM−2, 14 isolates (3.9%) harboured blaT EM−2 and blaCTX−M−15, eight isolates (2.2%) possessed blaSHV −3, blaT EM−2, and blaCTX−M−15. Discussion: The high prevalence of ESBLs in K. pneumoniaeisolates with diverse enzyme gene types indicated the need for screening the changes in ESBL-producing isolates in this region. Keywords ESBLs; Klebsiella pneumoniae; Molecular epidemiology