Interim Results
Klebsiella pneumoniae was the most common CPE species, accounting for 67% of the isolates, followed by Escherichia coli (21%), Citrobacter koseri (2%), Klebsiella aerogenes (2%), Enterobacter hormaechei (2%), Enterobacter asburiae (1%), Citrobacter freundii (1%), Klebsiella quasipneumoniae (1%), Klebsiella variicola (1%), Acinetobacter baumanii (0.3%), Pseudomonas aeruginosa (0.3%), Citrobacter europaeus (0.3%), Klebsiella grimontii (0.3%) and Morganella morganii (0.3%).
The most common carbapenemase found in K.pneumoniae and E. coli was OXA-48 like. Multilocus sequence typing (MLST) analysis revealed the presence of predominant sequence types among K. pneumoniae isolates. The most prevalent K. pneumoniae sequence type was ST147, followed by ST307 and ST13. Additionally, two isolates of the hypervirulent K. pneumoniae sequence type ST23 were identified, which also harboured OXA-48 like and SHV-11 genes.
In the case of E. coli, MLST, the predominant sequence type was ST127 followed by ST167.
Carbapenemases are most often located on genetic elements such as plasmids, which are mobile and can be easily shared among Enterobacteriaceae. Plasmids harbouring carbapenemase genes were identified in 97 % of K. pneumoniae isolates and 98% of E.coli isolates.
Fig 1 The phylogenetic analysis of carbapenem-producing K. pneumoniae. Isolates belonging with the same Sequence Type (ST), and CPE resistance genes were clustered together. The analysis identified 32 clusters.
Fig 2 The phylogenetic analysis of carbapenem-producing E.coli. Isolates belonging with the same Sequence Type (ST), and CPE resistance genes were clustered together. The analysis identified 10 clusters.