Trends and molecular characteristics of carbapenemase-producing Enterobacteriaceae in Japanese hospital from 2006 to 2015 |
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| Affiliation: | 1. Department of Environmental Microbiology, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan;2. Department of Microbiology, School of Allied Health Science, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0373, Japan;3. Infection Control Research Center, Kitasato Institute for Life Sciences, Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo, 108-8642, Japan;4. Department of Infection Control and Prevention, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0375, Japan;5. Department of Infection Control and Infectious Diseases, Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan;6. Department of Microbiology and Infectious Diseases, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8521, Japan;1. Department of Infection Control and Prevention, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0375, Japan;2. Department of General Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan;3. Department of Infection Control and Laboratory Diagnostics, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai 980-8574, Japan;4. Department of Virology, Kitasato Research Center for Environmental Science, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0329, Japan;5. Department of Microbiology and Immunology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan;6. Department of Microbiology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan;7. Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan;1. Department of Microbiology, Ziekenhuis Netwerk Antwerpen, Antwerp, Belgium;2. Department of Intensive Care, Ziekenhuis Netwerk Antwerpen, Antwerp, Belgium;1. Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia;2. Infection Control Unit, University Medical Centre Ljubljana, Ljubljana, Slovenia;3. Public Health Institute Ljubljana, Regional Unit Ljubljana, Ljubljana, Slovenia;1. Public Health England North West, Manchester, UK;2. Manchester University NHS Foundation Trust, Manchester, UK;3. Field Service North West, Liverpool, UK;1. Laboratorio de Antibióticos, Servicio de Bacteriología, Centro Nacional de Microbiología, Majadahonda, Madrid, Spain;2. Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau, Barcelona, Spain;3. Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Barcelona, Spain;1. Infection Control and Prevention Unit, CHU d’Angers, University of Angers, Angers, France;2. Data Management Research Department DRCI, Angers Hospital and SFR ICAT, University of Angers, Angers, France;3. Center for Research in Cancerology & Immunology Nantes-Angers, Institut National de la Santé et de la Recherche Médicale, Université de Nantes, Université d''Angers, Angers, France;4. Laboratoire de Bactériologie, IRIS, CHU d''Angers, Angers, France;5. Département de Microbiologie Clinique et Unité de Contrôle et de Prévention du risque Infectieux, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France;6. IAME, UMR 1137, Université Paris 13, Sorbonne Paris Cité, France |
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| Abstract: | BackgroundThe increasing number of carbapenemase-producing Enterobacteriaceae (CPE) has become a global problem. Most carbapenemases detected in Japan are imipenemase, which is an imipenem-degrading enzyme with low ability; thus, CPE could have been overlooked. Therefore, this study aimed to detect and analyze CPE, without overlooking CPE showing the low minimum inhibitory concentration phenotype.MethodsCPE screening was conducted on 531 ceftazidime-resistant Enterobacteriaceae isolated from Kitasato University Hospital during 2006–2015. We confirmed the presence of the carbapenemase genes (blaIMP, blaVIM, blaKPC, blaNDM, and blaOXA-48) by multiplex polymerase chain reaction. The detected CPE strains were analyzed by antimicrobial susceptibility testing, multilocus sequence typing, conjugal experiments, replicon typing, and plasmid profiling by restriction enzyme treatment.ResultsThe CPE detection rate in Kitasato University Hospital within the past 10 years was 0.0003% (nine CPE strains). These nine CPE strains were identified to harbor 8 blaIMP-1 or 1 blaNDM-5. The CPE strains consisted of five species including Klebsiella pneumoniae and Citrobacter freundii. Six of eight blaIMP-1 were coded by IncHI2 plasmid, and the other two were coded by IncA/C plasmid. Plasmid profiling revealed that K. pneumoniae and C. freundii isolated from the same patient harbored the same plasmid.ConclusionThe CPE detection rate in this study was significantly lower than those previously reported in Japan. In one case, IncA/C plasmid transmission through different bacterial species within the body was speculated. Although the number of CPE detected was low, these results indicated that the resistance plasmid could spread to other bacterial species. |
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| Keywords: | Carbapenemase Enterobacteriaceae Plasmid transmission IncA/C plasmid IncHI2 plasmid |
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