Molecular characterization of carbapenem resistance mechanisms and phenotypic correlations in clinical Klebsiella pneumoniae isolates from Ningbo, China
Abstract
OBJECTIVE: The purpose of this study is to understand the antimicrobial susceptibility and molecular distribution characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP) in the region, and to evaluate their correlation. Additionally, the study aims to investigate the transmission status of these strains.
METHODS: A total of 150 CRKP collected from January 2019 to December 2021 in the Ningbo region were included in this study. Antimicrobial susceptibility testing was performed using broth microdilution method following CLSI guidelines (CLSI, 2023). The tested agents included: (1) basic antimicrobials (tigecycline, polymyxin B, ceftazidime-avibactam); and (2) combination therapy candidates (ertapenem, imipenem, levofloxacin, piperacillin-tazobactam, ceftriaxone, cefepime, trimethoprim-sulfamethoxazole, fosfomycin, amikacin, aztreonam, chloramphenicol, amoxicillin-clavulanate, ceftazidime). Resistance genes were detected using polymerase chain reaction (PCR). Multi-locus sequence typing (MLST) was employed to analyze the molecular characteristics and evolutionary trends of the strains to determine their clonal relationships.
RESULTS: The 150 strains of CRKP exhibit high resistance rates to various conventional drugs; The sensitivity rates to tigecycline, polymyxin B, and ceftazidime-avibactam were 98.7, 98.0, and 68%, respectively; Conversely, the sensitivity rates to fosfomycin, amikacin, and chloramphenicol were 72.0, 40.0, and 16.7%, respectively; The main…
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