The plasmid-mediated fosfomycin resistance determinants and synergy of fosfomycin and meropenem in carbapenem-resistant Klebsiella pneumoniae isolates in Taiwan
Background: Epidemiology of fosfomycin susceptibility and the plasmid-mediated fosfomycinase genes of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates in Taiwan remain unclear. Methods: 642 CRKP clinical isolates were collected from a nation-wide surveillance study (16 hospitals) in Taiwan...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2017-10-01
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| Series: | Journal of Microbiology, Immunology and Infection |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118217300920 |
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| author | Sung-Pin Tseng Sheng-Fan Wang Ling Ma Ting-Yin Wang Tsung-Ying Yang L. Kristopher Siu Yin-Ching Chuang Pei-Shan Lee Jann-Tay Wang Tsu-Lan Wu Jung-Chung Lin Po-Liang Lu |
| author_facet | Sung-Pin Tseng Sheng-Fan Wang Ling Ma Ting-Yin Wang Tsung-Ying Yang L. Kristopher Siu Yin-Ching Chuang Pei-Shan Lee Jann-Tay Wang Tsu-Lan Wu Jung-Chung Lin Po-Liang Lu |
| author_sort | Sung-Pin Tseng |
| collection | DOAJ |
| description | Background: Epidemiology of fosfomycin susceptibility and the plasmid-mediated fosfomycinase genes of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates in Taiwan remain unclear.
Methods: 642 CRKP clinical isolates were collected from a nation-wide surveillance study (16 hospitals) in Taiwan in 2012–2013. Antimicrobial susceptibilities were determined. PFGE and MLST determined the clonal relatedness. Carbapenemases and fosfomycinases genes were detected by PCR, and their flanking regions were determined by PCR and sequencing. Synergistic activity of meropenem with fosfomycin was examined by the checkerboard method.
Results: In total, 36.4% (234/642) of CRKP isolates in Taiwan were resistant to fosfomycin. Among 234 fosfomycin-resistant CRKP isolates, PFGE analysis revealed 81 pulsotypes. Pulsotype XXIII (n = 63) was predominant and belonged to ST11. 71 had carbapnemases (65 blaKPC-2-positive, 1 blaVIM-1-positive and 5 blaIMP-8-positive) and 62 had fosfomycinases (35 fosA3-positive and 27 foskp96-positive). Only 18.5% (5/27) of foskp96-positive isolates carried foskp96 and blaKPC-2, while 71.4% (25/35) of fosA3-positive isolates contained fosA3 and blaKPC-2. There were five types of flanking sequences for fosA3, and 85.7% (30/35) of fosA3 genes were flanked by IS26, suggesting possible horizontal gene transfer. Synergistic effect of fosfomycin and meropenem was observed in all 25 randomly selected pulsotype XXIII strains (100%; 25/25), even those containing fosfomycinase (48%, 12/25) or carbapnemase (96%, 24/25).
Conclusions: A clone (pulsotype XXIII, ST11) has been found to be prevailing among fosfomycin-resistant CRKP in Taiwan. According to the in vitro data, the combination of fosfomycin and meropenem is a potentially alternative choice. |
| first_indexed | 2024-12-23T19:53:48Z |
| format | Article |
| id | doaj.art-f86a2e1d49fe4214825e91be174fc745 |
| institution | Directory Open Access Journal |
| issn | 1684-1182 |
| language | English |
| last_indexed | 2024-12-23T19:53:48Z |
| publishDate | 2017-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Microbiology, Immunology and Infection |
| spelling | doaj.art-f86a2e1d49fe4214825e91be174fc7452022-12-21T17:33:17ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822017-10-0150565366110.1016/j.jmii.2017.03.003The plasmid-mediated fosfomycin resistance determinants and synergy of fosfomycin and meropenem in carbapenem-resistant Klebsiella pneumoniae isolates in TaiwanSung-Pin Tseng0Sheng-Fan Wang1Ling Ma2Ting-Yin Wang3Tsung-Ying Yang4L. Kristopher Siu5Yin-Ching Chuang6Pei-Shan Lee7Jann-Tay Wang8Tsu-Lan Wu9Jung-Chung Lin10Po-Liang Lu11Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, TaiwanNational Institutes of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, TaiwanDepartment of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, TaiwanNational Institutes of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, TaiwanDepartment of Internal Medicine and Medical Research, Chi Mei Medical Center, Tainan, TaiwanDepartment of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Clinical Pathology, Linkou Chang Gung Memorial Hospital, Taoyuan, TaiwanDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDepartment of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanBackground: Epidemiology of fosfomycin susceptibility and the plasmid-mediated fosfomycinase genes of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates in Taiwan remain unclear. Methods: 642 CRKP clinical isolates were collected from a nation-wide surveillance study (16 hospitals) in Taiwan in 2012–2013. Antimicrobial susceptibilities were determined. PFGE and MLST determined the clonal relatedness. Carbapenemases and fosfomycinases genes were detected by PCR, and their flanking regions were determined by PCR and sequencing. Synergistic activity of meropenem with fosfomycin was examined by the checkerboard method. Results: In total, 36.4% (234/642) of CRKP isolates in Taiwan were resistant to fosfomycin. Among 234 fosfomycin-resistant CRKP isolates, PFGE analysis revealed 81 pulsotypes. Pulsotype XXIII (n = 63) was predominant and belonged to ST11. 71 had carbapnemases (65 blaKPC-2-positive, 1 blaVIM-1-positive and 5 blaIMP-8-positive) and 62 had fosfomycinases (35 fosA3-positive and 27 foskp96-positive). Only 18.5% (5/27) of foskp96-positive isolates carried foskp96 and blaKPC-2, while 71.4% (25/35) of fosA3-positive isolates contained fosA3 and blaKPC-2. There were five types of flanking sequences for fosA3, and 85.7% (30/35) of fosA3 genes were flanked by IS26, suggesting possible horizontal gene transfer. Synergistic effect of fosfomycin and meropenem was observed in all 25 randomly selected pulsotype XXIII strains (100%; 25/25), even those containing fosfomycinase (48%, 12/25) or carbapnemase (96%, 24/25). Conclusions: A clone (pulsotype XXIII, ST11) has been found to be prevailing among fosfomycin-resistant CRKP in Taiwan. According to the in vitro data, the combination of fosfomycin and meropenem is a potentially alternative choice.http://www.sciencedirect.com/science/article/pii/S1684118217300920FosfomycinCarbapenem resistancefosA3foskp96blaKPC-2 |
| spellingShingle | Sung-Pin Tseng Sheng-Fan Wang Ling Ma Ting-Yin Wang Tsung-Ying Yang L. Kristopher Siu Yin-Ching Chuang Pei-Shan Lee Jann-Tay Wang Tsu-Lan Wu Jung-Chung Lin Po-Liang Lu The plasmid-mediated fosfomycin resistance determinants and synergy of fosfomycin and meropenem in carbapenem-resistant Klebsiella pneumoniae isolates in Taiwan Journal of Microbiology, Immunology and Infection Fosfomycin Carbapenem resistance fosA3 foskp96 blaKPC-2 |
| title | The plasmid-mediated fosfomycin resistance determinants and synergy of fosfomycin and meropenem in carbapenem-resistant Klebsiella pneumoniae isolates in Taiwan |
| title_full | The plasmid-mediated fosfomycin resistance determinants and synergy of fosfomycin and meropenem in carbapenem-resistant Klebsiella pneumoniae isolates in Taiwan |
| title_fullStr | The plasmid-mediated fosfomycin resistance determinants and synergy of fosfomycin and meropenem in carbapenem-resistant Klebsiella pneumoniae isolates in Taiwan |
| title_full_unstemmed | The plasmid-mediated fosfomycin resistance determinants and synergy of fosfomycin and meropenem in carbapenem-resistant Klebsiella pneumoniae isolates in Taiwan |
| title_short | The plasmid-mediated fosfomycin resistance determinants and synergy of fosfomycin and meropenem in carbapenem-resistant Klebsiella pneumoniae isolates in Taiwan |
| title_sort | plasmid mediated fosfomycin resistance determinants and synergy of fosfomycin and meropenem in carbapenem resistant klebsiella pneumoniae isolates in taiwan |
| topic | Fosfomycin Carbapenem resistance fosA3 foskp96 blaKPC-2 |
| url | http://www.sciencedirect.com/science/article/pii/S1684118217300920 |
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