Study on the relationship between CRKP resistance gene detection and transmission in a tertiary hospital / 中华检验医学杂志

ABSTRACT

Objective:To explore the whole genome sequencing of carbapenem resistant Klebsiella pneumoniae (CRKP), reveal the prevalence of drug-resistance in CRKP, and guide the prevention and control of nosocomial infection. Methods:The CRKP isolates in Bengbu Third People′s Hospital from November 2018 to March 2019 was collected, and the strain identification and drug susceptibility testing were carried out using VITEK-2 Compact analyzer. The whole genome of selected CRKP was sequenced by Illumina Hiseq 2500 platform, spliced with spades-2.0 sequence, analyzed and extracted the core gene and drug-resistant genotype by cgMLST, and constructed the bacterial association map and transmission map by Scotti software.Results:Among the 19 CRKP strains, 13 were CT3176 genotype, 2 were CT1313 and 2 were CT1689, and 2 were other CRKP strains. CT3176 was distributed mainly in the Department of critical care medicine and was in epidemic status. The strains mainly carried blaKPC-2 (19/19), blaCTX-M-65 (19/19), blaSHV-11 (16/19), blaTEM-1B (14/19), and aminoglycosides. Among them, aadA2 (14/19), rmtB (14/19), AAC(3)-Ⅱd (12/19), armA (11/19), mph (E) (11/19), msr (E) (11/19), mph (A) (10/19), fosA6 (19/19) and other resistant genes were detected. Software analysis showed that the strains numbered 7 and 29, and strains numbered 12 and 17 had 42% and 37% transmission rate repectively, but that of the other strains remain low.Conclusions:By using the whole genome sequencing of microorganisms, strain typing, drug resistance genes, and the homology of strains can be determined, strain association map and transmission map can be built. That can effectively guide the development of nosocomial infection prevention and control in hospitals.