Molecular Characterization of Carbapenem-Resistant Enterobacteriaceae in the USA, 2011–2015
Year: 2017
Type: conference-abstract
Abstract: Carbapenem-resistant Enterobacteriaceae (CRE) have emerged as an important cause of healthcare-associated infections. We characterized the molecular epidemiology of CRE in isolates collected through the Emerging Infections Program (EIP) at the Centers for Disease Control and Prevention (CDC). From 2011–2015, 8 U.S. EIP sites (CO, GA, MD, MN, NY, NM, TN and OR) collected CRE (Escherichia coli, Enterobacter aerogenes, Enterobacter cloacae complex, Klebsiella pneumoniae, and Klebsiella oxytoca) isolated from a normally sterile site or urine. Isolates were sent to CDC for reference antimicrobial susceptibility testing and real-time PCR detection of carbapenemase genes (blaKPC, blaNDM, blaOXA-48). Phenotypically confirmed CRE were analyzed by whole genome sequencing (WGS) using an Illumina MiSeq benchtop sequencer. Among 639 Enterobacteriaceae evaluated, 414 (65%) were phenotypically confirmed as CRE using CDC’s current surveillance definition (resistant to ertapenem, imipenem, doripenem, or meropenem). Among isolates confirmed as CRE, 303 (73%) were carbapenemase-producers (CP-CRE). The majority of CP-CRE originated from GA (39%), MD (35%) and MN (11%); most non-CP-CREs originated from MN (27%), CO (25%) and OR (17%). K. pneumoniae was the predominant carbapenemase-producing species (78%) followed by E. cloacae complex spp (12%), E. coli (7.9%), E. Aerogenes (0.9%) and K. oxytoca (0.6%). The most common carbapenemase genes detected were blaKPC-3 (76%) and blaKPC-2 (19%); blaNDM and blaOXA-48-like genes were detected in 1.6% and 0.3% of isolates, respectively. For carbapenemase-producing K. pneumoniae, Enterobacter spp, and E. coli, the predominant sequence types (ST) were ST258 (65%), ST171 (35%) and ST131 (29%), respectively. The distribution of CP and non-CP-CRE varied across the catchment sites. Among CP-CRE, KPC-producing K. pneumoniae predominated; other carbapenemases were rarely identified in the locations under surveillance. Strain types known to have increased epidemic potential (ST258 and ST131) were common among carbapenemase-producing K. pneumoniae and E. coli isolates, respectively. All authors: No reported disclosures.
Source: Open Forum Infectious Diseases
Authors: Uzma Ansari, Adrian Lawsin, Davina Campbell, Valerie Albrecht, Gillian McAllister, Sandra Bulens, Maroya Spalding Walters, Jesse T Jacob, Sarah W Satola, Lucy E Wilson, Ruth Lynfield, Paula M Snippes Vagnone, Sarah J Janelle, Karen Xavier, Ghinwa Dumyati, Dwight Hardy, Erin C Phipps, Karissa Culbreath, Zintars Beldavs, Karim Morey, Marion A Kainer, Sheri Roberts, Alexander Kallen, J Kamile Rasheed, Maria S Karlsson
Institutions: Centers for Disease Control and Prevention, Emory University, Maryland Department of Health, Minnesota Department of Health, Colorado Department of Public Health and Environment, University of Rochester Medicine, University of New Mexico, Oregon Health Authority, Tennessee Department of Health
Language: English
Subfield: Microbiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,053
OpenAlex ID: W2747324381