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Molecular Analysis of Carbapenem-Resistant Enterobacteriaceae at a South Korean Hospital

Microbiology and Biotechnology Letters 2020년 48권 3호 p.389 ~ 398
이미영, 최태진,
소속 상세정보
이미영 ( Lee Mi-Young ) - Pukyoung National University Department of Microbiology
최태진 ( Choi Tae-Jin ) - Pukyong National University Department of Microbiology

Abstract


The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) is increasing globally, resulting in high mortality rates. Although CRE is a relatively recent problem in Korea (the first case was not diagnosed until 2010), it is responsible for serious morbidities at an alarming rate. In this study, we carried out a molecular genetic analysis to determine the incidence of CRE and carbapenemase-producing Enterobacteriaceae (CPE) at a general hospital in Korea between August 2017 and August 2019. Forty strains of CPE were isolated from various clinical specimens and analyzed via antimicrobial susceptibility testing, polymerase chain reaction to detect β-lactamase genes, deoxyribonucleic acid sequencing, multilocus sequence typing, curing testing, and conjugal transfer of plasmids. The results demonstrated that all 40 isolates were multidrug- resistant. The fluoroquinolone susceptibility test showed that 75% of the Enterobacteriaceae isolates were resistant to ciprofloxacin, whereas 72.5% were resistant to trimethoprim-sulfamethoxazole. Further, conjugation accounted for 57.5% of all resistant plasmid transfer events, which is 4.3-fold higher than that observed in 2010 by Frost et al. Finally, the high detection rate of transposon Tn4401 was associated with the rapid diffusion and evolution of CPE. Our results highlight the rapid emergence of extensively drugresistant strains in Korea and emphasize the need for employing urgent control measures and protocols at the national level.

키워드

Fluoroquinolone; blaKPC; Escherichia coli ST410; Klebsiella pneumoniae ST307; carbapenem-resistant Enterobacteriaceae; carbapenemase-producing Enterobacteriaceae

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