Molecular and Clinical Characteristics of Carbapenem-Resistant Klebsiella pneumoniae Isolates at a Tertiary Hospital in Wuhan, China

Figures & data

Table 1 Clinical Characteristics of CRKP Patients

	Number	%
Sex
Male	33	73.33
Female	12	26.67
Infection source
Lavage fluid	9	20.00
Sputum	36	80.00
ICU admission
+	43	95.56
–	2	4.44
Age
>69 years	22	48.89
≤69 years	23	51.11
Basic diseases
Hypertension/diabetes/coronary heart disease/tumor	35	77.78
No diseases	10	22.22
Surgery
+	25	55.56
–	20	44.44
Invasive ventilation
+	37	82.22
–	8	17.78
Prior length of stay
>21days	22	48.89
≤21days	23	51.11
Prior antibiotic exposure
>4	19	42.22
≤4	26	57.78
Infection source
Pneumonia	34	75.56
Bloodstream Infection	11	24.44
Permanent disability
+	7	15.56
–	38	84.44
Complication
Heart failure/Renal failure/Hepatic failure/Stroke/DIC	37	82.22
No complication	8	17.78
Prognosis
Death	13	28.89
Alive	32	71.11

Figure 1 Phylogenetic tree of MDR-KP strains based on SNP analysis. HS11286_CO4P003200_ST11 was used as the reference genome, and BacWGSTdb 2.0 database was used to draw the phylogenetic tree based on SNP analysis of 45 MDR-KP strains collected from Wuhan, China. The results showed that the bacteria were mainly divided into 4 groups.

Table 2 Antimicrobial Susceptibility

Antibiotic	R%	S%	I%
Ampicillin	45(100.00)	0	0
Levofloxacin	45(100.00)	0	0
Ciprofloxacin	45(100.00)	0	0
Cefoxitin	45(100.00)	0	0
Ceftriaxone	45(100.00)	0	0
Aztreonam	45(100.00)	0	0
Amoxicillin–clavulanate	45(100.00)	0	0
Imipenem	45(100.00)	0	0
Piperacillin-tazobactam	45(100.00)	0	0
Cefepime	43(95.56)	0	2(4.44)
Gentamicin	39(86.67)	5(11.11)	1(2.22)
Amikacin	39(86.67)	6(13.33)	0
Tobramycin	39(86.67)	6(13.33)	0
Sulfamethoxazole/trimethoprim	31(68.89)	14(31.11)	0

Table 3 Resistance Genes of 45 CRKP Isolates

Type	Resistance Gene	Positive Strains	Percentage
β-lactam	blaKPC-1	43	95.56%
	blaCTX-M-65	41	91.11%
	blaCTX-M-15	1	2.22%
	blaCTX-M-55	1	2.22%
	blaCTX-M-3	1	2.22%
	blaSHV-134	11	24.44%
	blaSHV-182	40	88.89%
	blaSHV-172	1	2.22%
	blaTEM-141	1	2.22%
	blaTEM-1	40	88.89%
Aminoglycoside	rmtB	39	86.67%
	aadA2	36	80.00%
	aadA8b	1	2.2%
	APH(3ʹ)-Ia	19	42.2%
	APH(6)-Id	2	4.44%
	APH(3″)-Ib	2	4.44%
	AAC(3)-IIe	1	2.22%
uinolone	oqxB	7	15.56%
	oqxA	7	15.56%
	QnrB2	1	2.22%
	QnrB1	1	2.22%
	QnrS1	11	24.44%
Sulfonamide	sul1	37	82.22%
	sul2	11	24.44%
Streptomycin	mphA	20	44.47%
Fosfomycin	FosA6	45	100.00%
	FosA3	3	6.67%
Chloramphenicol	floR	2	4.44%
Tetracycline	tet(A)	12	26.67%

Table 4 Virulence Genes of 45 CRKP Isolates

Virulence Gene Type	Virulence Factors	Positive Strains	Percentage
Adhesive virulence gene	fimA	45	100.00%
	fimE	17	37.78%
	fimB	1	2.22%
	yagV/ecpE	45	100.00%
	yagW/ecpD	45	100.00%
	yagX/ecpC	45	100.00%
	yagY/ecpB	45	100.00%
	yagZ/ecpA	45	100.00%
	ykgK/ecpR	45	100.00%
Iron-absorption virulence gene	fepD	45	100.00%
	fepG	45	100.00%
	fepC	45	100.00%
	fepA	45	100.00%
	fepB	45	100.00%
	entA	45	100.00%
	entB	45	100.00%
	entE	45	100.00%
	entS	45	100.00%
	iroB	1	2.22%
	iroC	1	2.22%
	iroD	1	2.22%
	iroN	10	22.22%
	ybtE	44	97.78%
	ybtT	44	97.78%
	ybtU	44	97.78%
	ybtA	44	97.78%
	ybtP	44	97.78%
	ybtQ	44	97.78%
	ybtX	44	97.78%
	ybtS	44	97.8%
	iucD	10	22.22%
	iucC	10	22.22%
	iucB	10	22.22%
	iucA	10	22.22%
Invasive virulence gene	ompA	45	100.00%