Prevalence of bla NDM−1 -producing Klebsiella pneumoniae in Asia: A systematic review and meta-analysis

A longitudinal epidemiology study of fluoroquinolone-nonsusceptible Klebsiella pneumoniae reveals an increasing prevalence of qnrB and qnrS in Taiwan

BACKGROUND

Our objective was to investigate the prevalence of plasmid-mediated quinolone resistance (PMQR) genes in fluoroquinolone-nonsusceptible Klebsiella pneumoniae (FQNSKP) in Taiwan, 1999-2022.

METHODS

A total of 938 FQNSKP isolates were identified from 1966 isolates. The presence of PMQR and virulence genes, antimicrobial susceptibility, capsular types, and PMQR-plasmid transferability were determined.

RESULTS

An increasing number of PMQR-containing FQNSKP isolates were observed over the study period. Our results showed that 69.0% (647 isolates) of FQNSKP isolates contained at least one PMQR gene, and 40.6%, 37.0%, and 33.9% of FQNSKP carried aac(6')-Ib-cr, qnrB, and qnrS, respectively. None of FQNSKP carried qepA and qnrC. The most common combination of PMQR genes was aac(6')-Ib-cr and qnrB (12.3%). The presence of PMQR genes is strongly related to resistance to aminoglycoside, cephalosporin, tetracycline, and sulfamethoxazole/trimethoprim in FQNSKP. The capsular serotype K64 is the most common serotype we tested in both the non-PMQR and PMQR FQNSKP isolates, while K20 showed a higher prevalence in PMQR isolates. The magA and peg-344 genes showed a significantly higher prevalence rate in non-PMQR isolates than in PMQR isolates. Eleven isolates that carried the PMQR and carbapenemase genes were identified; however, three successful transconjugants showed that the PMQR and carbapenemase genes were not located on the same plasmid.

CONCLUSIONS

Our results indicated an increasing prevalence of PMQR genes, especially qnrB and qnrS, in FQNSKP in Taiwan. Moreover, the distribution of PMQR genes was associated with capsular serotypes and antimicrobial resistance gene and virulence gene distribution in FQNSKP.

Frequency distribution, genotypes and prevalent sequence types of New Delhi metallo-β-lactamase-producing Escherichia coli among clinical isolates around the world: A review

OBJECTIVES

New Delhi metallo-β-lactamase (NDM)-producing Escherichia coli is perceived as one of the primary multidrug-resistant bacteria causing infections in hospitals and clinics. In this review, we present the frequency distribution, genotypes and most prevalent sequence types (STs) of NDM-producing E. coli among clinical isolates worldwide.

METHODS

Several international databases, including Medline, Embase, Scopus and Web of Science, were searched from 2008 to 2018 to identify studies addressing the prevalence of NDM-producing E. coli around the world.

RESULTS

Of 974 records identified from the databases, 110 studies fulfilled the eligibility criteria and were included in this analysis. The prevalence of NDM-producing E. coli was 82.6%, 12.9%, 1.5%, 1.0% and 2.0% in Asia, Europe, America, Africa and Oceania, respectively. The most common reported STs among NDM-producing E. coli were ST101, ST167, ST131, ST405, ST410 and ST648.

CONCLUSION

The spread of NDM variants among E. coli strains is a serious threat to global public health. In addition, the most prevalent E. coli clonal groups, such as ST101 and ST167, are one of the main causes of E. coli infection in different countries.