Nationwide Surveillance of Clinical Carbapenem-resistant Enterobacteriaceae (CRE) Strains in China

Research output: Journal Publications and Reviews (RGC: 21, 22, 62)21_Publication in refereed journalpeer-review

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Author(s)

  • Rong Zhang
  • Lizhang Liu
  • Hongwei Zhou
  • Edward Waichi Chan
  • Jiaping Li
  • Ying Fang
  • Yi Li
  • Kang Liao

Detail(s)

Original languageEnglish
Pages (from-to)98-106
Journal / PublicationEBioMedicine
Volume19
Online published26 Apr 2017
Publication statusPublished - 1 May 2017
Externally publishedYes

Abstract

The increasing incidence of carbapenem-resistant Enterobacteriaceae (CRE) - mediated hospital infections in China prompted a need to investigate the genetic basis of emergence of such strains. A nationwide survey was conducted in China covering a total of 1105 CRE strains collected from 25 geographical locales with results showing that acquisition of two carbapenemase genes, blaKPC-2 and blaNDM, was responsible for phenotypic resistance in 90% of the CRE strains tested (58% and 32% respectively), among which several major strain types, such as ST11 of K. pneumoniae and ST131/ST167 of E. coli, were identified, suggesting that dissemination of specific resistant clones is mainly responsible for emergence of new CRE strains. Prevalence of the fosA3 gene which mediates fosfomycin resistance, was high, while the colistin resistance determinant mcr-1 was rarely present in these isolates. Consistently, the majority of the blaNDM-bearing plasmids recoverable from the test strains belonged to IncX3, which contained a common core structure, blaNDM-blaMBL-trpF. Likewise, the core structure of ISKpn27-blaKPC-2-ISKpn2 was observed among plasmids harboring the blaKPC-2 gene, although they were genetically more divergent. In conclusion, the increasing prevalence of CRE strains in China is attributed to dissemination of conservative mobile elements carrying blaNDM or blaKPC-2 on conjugative and non-conjugative plasmids.

Research Area(s)

  • blaKPC-2, blaNDM, Carbapenem resistance, Enterobacteriaceae, Molecular epidemiology, Plasmid

Citation Format(s)

Nationwide Surveillance of Clinical Carbapenem-resistant Enterobacteriaceae (CRE) Strains in China. / Zhang, Rong; Liu, Lizhang; Zhou, Hongwei; Chan, Edward Waichi; Li, Jiaping; Fang, Ying; Li, Yi; Liao, Kang; Chen, Sheng.

In: EBioMedicine, Vol. 19, 01.05.2017, p. 98-106.

Research output: Journal Publications and Reviews (RGC: 21, 22, 62)21_Publication in refereed journalpeer-review