High Prevalence of Klebsiella pneumoniae Infections in AnHui Province: Clinical Characteristic and Antimicrobial Resistance

Figures & data

Table 1 Primer Sequence About Virulence and Resistance Associated Genes

Prime Name		Sequence
rmpA	Forward	ACTGGGCTACCTCTGCTTCA
	Reverse	CGCACCAGTAATTCCAACAG
rmpA2	Forward	CTTTATGTGCAATAAGGATGTT
	Reverse	CCTCCTGGAGAGTAAGCATT
K1	Forward	GGTGCTCTTTACATCATTGC
	Reverse	GCAATGGCCATTTGCGTTAG
K2	Forward	GGAGCCATTTGAATTCGGTG
	Reverse	TCCCTAGCACTGGCTTAAGT
K5	Forward	GCCACCTCTAAGCATATAGC
	Reverse	CGCACCAGTAATTCCAACAG
K20	Forward	CCGATTCGGTCAACTAGCTT
	Reverse	GCACCTCTATGAACTTTCAG
K54	Forward	CATTAGCTCAGTGGTTGGCT
	Reverse	GCTTGACAAACACCATAGCAG
KPC-2	Forward	ATGTCACTGTATCGCCGTCT
	Reverse	TTTTCAGAGCCTTACTGCCC
NDM-1	Forward	GGTTTGGCGATCTGGTTTTC
	Reverse	CGGAATGGCTCATCACGATC
VIM-1	Forward	AAATTCCGGTCGGAGAGGTC
	Reverse	AATGCGCAGCACCAGGATAG
IMP-1	Forward	GGAATAGAGTGGCTTAATTCTCC
	Reverse	GGTTTAATAAAACAACCACC
OXA-48	Forward	GCGTGGTTAAGGATGAACAC
	Reverse	CATCAAGTTCAACCCAACCG

Table 2 Clinical and Microbiological Characteristics of HvKP Isolates

Characteristics	NO.(%) of Isolates		P value
	HvKP (n=68)	Non-HvKP (n=47)
Demographic characteristics
Male sex	43 (63.2)	35 (74.5)	0.205
Age (years) (mean ± SD)	57.01 ± 19.00	57.26 ± 16.20	0.944
K serotypes
K1	21/68 (30.9)	2/47 (4.3)	0.000
K2	26/68 (38.2)	9/47 (19.1)	0.029
K5	12/68 (17.6)	4/47 (8.5)	0.164
K20	0/68 (0.0)	2/47 (4.3)	0.086
K57	8/68 (11.8)	1/47 (2.1)	0.059
Antimicrobial susceptibility
Ceftazidime	13/68 (19.1)	12/47 (25.5)	0.093
Ceftriaxone	14/68 (20.6)	15/47 (32.0)	0.028
Cefepime	13/68 (19.1)	11/47 (23.4)	0.030
Cefotaxime	14/68 (20.6)	15/47 (32.0)	0.028
Piperacillin-tazobactam	12/68 (17.6)	9/47 (19.1)	0.273
Cefoperazone-sulbactam	13/68 (19.1)	10/47 (21.3)	0.254
Imipenem	12/68 (17.6)	10/47 (21.3)	0.168
Meropenem	12/68 (17.6)	10/47 (21.3)	0.168
Amikacin	12/68 (17.6)	6/47 (12.8)	0.872
Gentamicin	13/68 (19.1)	10/47 (21.3)	0.254
Ciprofloxacin	15/68 (22.1)	14/47 (29.8)	0.082
Levofloxacin	14/68 (20.6)	13/47 (27.7)	0.088
Aztreonam	15/68 (22.1)	14/47 (29.8)	0.082
Tigecycline	0/68 (0)	-	-
Colistin	0/68 (0)	-	-
Carbapenemase	12/68 (17.6)	11/47 (23.4)	0.448
Diseases
Cancer	7 (10.3)	12 (25.5)	0.031
Liver abscess	8 (11.8)	1 (0.02)	0.059
Hypertension	21 (44.7)	15 (32.0)	0.907
Diabetes	18 (26.5)	8 (17.0)	0.234
Pulmonary disease	19 (28.0)	12 (25.5)	0.775
Invasive equipment	33 (48.5)	21 (44.7)	0.684

Figure 1 Distribution percentage of 68 strains of HvKP.

Table 3 Clinical and Microbiological Characteristics of Carbapenemase Producing HvKP Isolates

	Strain4	Strain7	Strain16	Strain29	Strain32	Strain34	Strain35	Strain37	Strain38	Strain51	Strain55	Strain68
Demographic characteristics
Gender	Male	Male	Male	Male	Female	Female	Male	Male	Male	Male	Female	Male
Age	56	52	46	54	53	33	29	81	55	50	60	44
Microbiological characteristics
Virulence-associated features
String test	+	+	+	+	+	+	+	+	+	+	+	+
rmpA	+	+	+	+	+	+	+	+	+	+	+	+
rmpA2	+	+	+	+	+	+	+	+	+	+	+	+
Cps genotype	K14/K64	K14/K64	K14/K64	K14/K64	K14/K64	K14/K64	K14/K64	K14/K64	K14/K64	K2	No-K-type	K14/K64
MLST	ST11	ST11	ST11	ST11	ST11	ST11	ST11	ST11	ST11	ST25	ST11	ST11
Resistance-associated features
KPC-2	+	+	+	+	-	+	+	+	+	-	+	+
NDM-1	-	+	+	+	+	-	+	+	+	+	+	+
VIM-1	+	+	+	+	+	+	+	+	+	-	+	+
IMP-1	-	-	-	-	-	-	-	-	-	-	-	-
OXA-48	+	+	+	+	+	+	+	+	+	+	+	+
Clinical characteristics
Specimen type	Sputum	Secretions	Sputum	Blood	Venous catheter	Sputum	Sputum	Sputum	Sputum	Sputum	Sputum	Puncture fluid
Infection type	Pneumonia	Pneumonia	Pneumonia	Pneumonia	Pneumonia	Pneumonia	Sepsis	Sepsis	Pneumonia	Pneumonia	Pneumonia	Abdominal infection
Clinical outcomes	Survived	Survived	Survived	Survived	Survived	Survived	Died	Died	Died	Survived	Survived	Survived

Figure 2 Pulsed field gel electrophoresis (PFGE) cluster analysis of 68 strains of HvKP from different sources. Four highly homologous isolates from carbapenemase producing HvKP have been marked with a black circle to the serial number left.