Evidence of Sharing of Carbapenem-Resistant Klebsiella pneumoniae Strains Between Intensive Care Unit Patients and the Environment

Figures & data

Table 1 Primer Sequence, Product Length and Annealing Temperature of β-Lactamase Genes

β-Lactamase Gene	Primer Sequence (5′→3′)	Annealing Temperature (°C)	Product Length (bp)
SHV	F: ATGCGTTATATTCGCCTGTG	56	861
	R: TTAGCGTTGCCAGTGCTCGATC
TEM	F:GAGTATTCAACATTTCCGTGTCGC	56	858
	R: TACCAATGCTTAATCAGTGAGGC
KPC	F:ATGTCACTGTATCGCCGTCT	56	893
	R:TTTTCAGAGCCTTACTGCCC
NDM	F:ATGGAATTGCCCAATATTATGC	56	813
	R:TCAGCGCAGCTTGTCGG
VIM	F:TTATGGAGCAGCAACGATGT	55	920
	R:CAAAAGTCCCGCTCCAACGA
IMP	F:TGAGCAAGTTATCTGTATTC	55	740
	R:TTAGTTGCTTGGTTTTGATG
0XA-48	F:GCGTGGTTAAGGATGAACAC	57	438
	R:CATCAAGTTCAACCCAACCG

Table 2 Screening Results and β-Lactamase Gene of Carbapenem-Resistant Klebsiella pneumoniae

Source	Isolate ID	Date	Location			β-Lactamase Gene
			Ward	Bed Number	Sampling Point
E	132	Sept.28th	ICU/A	2	Ventilator	blaOXA-48, blaSHV, blaTEM
E	141	Sept.28th	ICU/A	2	Bed rail	blaOXA-48, blaSHV, blaTEM
E	147	Sept.28th	ICU/A	/	Nurse station	blaOXA-48, blaSHV, blaTEM
E	161	Sept.28th	ICU/A	2	Stethoscope	blaSHV, blaIMP
E	165	Sept.28th	ICU/A	2	Bed rail	blaOXA-48, blaSHV, blaTEM
E	225	Oct.10th	ICU/A	6	Stethoscope	blaOXA-48, blaSHV, blaTEM
E	236	Oct.10th	ICU/B	11	Computer	blaOXA-48, blaSHV, blaTEM
E	240	Oct.10th	ICU/A	6	Bed rail	blaSHV, blaTEM, blaIMP
E	243	Oct.10th	ICU/A	2	Computer	blaSHV, blaTEM, blaIMP
E	279	Oct.17th	ICU/A	/	Nurse station	blaOXA-48, blaSHV, blaTEM
E	333	Oct.17th	ICU/A	1	Bed rail	blaOXA-48, blaSHV, blaTEM
E	335	Oct.17th	ICU/A	/	Rack	blaOXA-48, blaSHV, blaTEM
E	336	Oct.17th	ICU/A	1	Computer	blaSHV, blaTEM, blaIMP
E	337	Oct.17th	ICU/A	2	Stethoscope	blaOXA-48, blaSHV, blaTEM
E	338	Oct.17th	ICU/A	2	Bedside table	blaOXA-48, blaSHV, blaTEM
E	339	Oct.17th	ICU/A	4	Stethoscope	blaOXA-48, blaSHV, blaTEM
E	340	Oct.17th	ICU/A	5	Stethoscope	blaOXA-48, blaSHV, blaTEM
E	343	Oct.17th	ICU/A	4	Computer	blaOXA-48, blaSHV, blaTEM
E	344	Oct.17th	ICU/A	1	Stethoscope	blaOXA-48, blaSHV, blaTEM
E	345	Oct.17th	ICU/B	9	Stethoscope	blaOXA-48, blaSHV, blaTEM
P	97	Jul.6th	RICU	/	/	blaNDM-1, blaSHV, blaTEM
P	102	Jul.6th	RICU	/	/	blaNDM-1, blaSHV, blaTEM
P	203	Sept.27th	ICU/A	2	/	blaOXA-48, blaSHV, blaTEM
P	207	Oct.10th	ICU/A	2	/	blaOXA-48, blaSHV, blaTEM
P	223	Oct.12th	ICU/A	1	/	blaOXA-48, blaSHV, blaTEM
P	229	Oct.22nd	ICU/A	3	/	blaOXA-48, blaSHV, blaTEM
P	237	Nov.17th	ICU/A	2	/	blaOXA-48, blaSHV

Abbreviations: E, environment; P, patient.

Figure 1 Distribution of carbapenem-resistant Klebsiella pneumoniae in intensive care units. Both environmental and patient strains were isolated (yellow), red means only patient strains were isolated and green means only environmental strains were isolated. The respiratory intensive care unit and the comprehensive intensive care unit are not in the same building, and the tested wards are highlighted with a black border.

Figure 2 Dendrogram showing pulsed-field gel electrophoresis (PFGE) analysis of the 27 carbapenem-resistant Klebsiella pneumoniae isolates.

Table 3 Minimum Inhibitory Concentrations (MIC) for Imipenem and Meropenem of the Carbapenem-Resistant Klebsiella pneumoniae Isolate and Its Transconjugant

Isolate	MIC
	Impipenem	Meropenem
236	16	8
TC-236	4	4
E coli J53	0.5	≤0.125

Abbreviations: TC, transconjugant strain; E coli J53, recipient strain.