RT Journal Article SR Electronic(1) A1 Yu, Feng A1 Hu, Longhua A1 Zhong, Qiaoshi A1 Hang, Yaping A1 Liu, Yanling A1 Hu, Xiaoyan A1 Ding, Hui A1 Chen, Yanhui A1 Xu, Xiuhua A1 Fang, Xueyao A1 Yu, FangyouYR 2019 T1 Dissemination of Klebsiella pneumoniae ST11 isolates with carbapenem resistance in integrated and emergency intensive care units in a Chinese tertiary hospital JF Journal of Medical Microbiology, VO 68 IS 6 SP 882 OP 889 DO https://doi.org/10.1099/jmm.0.000981 PB Microbiology Society, SN 1473-5644, AB Purpose. The aim of the present study was to investigate the dissemination of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates in integrated intensive care units (IICUs) and emergency ICUs (EICUs) for controlling the spread of CRKP in different ICUs of the hospital. Methodology. From January 2016 to April 2017, a total of 46 non-duplicate CRKP isolates were consecutively isolated from a tertiary hospital. The production of carbapenemases was determined by the modified carbapenem inactivation method (mCIM) test. The resistance and virulence-associated genes were detected by PCR and DNA sequencing. A hypermucoviscosity phenotype was identified by the string test. Bacterial clonal relatedness of the CRKP isolates tested was determined by multi-locus sequence typing (MLST) and PFGE. Results. All CRKP isolates showed multiple drug resistance. All CRKP isolates harboured bla KPC-2-encoding carbapenemase and at least one of the other β-lactamase genes tested, with positive rates of 89.1  % (41/46) for bla CTX-M-65. qnrS was found among 76.1  % (35/46) of the CRKP isolates. A hypermucoviscosity phenotype was found in only two (4.3 %, 2/46) CRKP isolates. The virulence-associated genes with positive rates of more than 90  % among the 46 isolates tested included wabG (100 %, 46/46), ycf (100 %, 46/46), ureA (95.6 %, 44/46) and fim H (95.6 %, 44/46). MLST results showed that 46 CRKP isolates belonged to ST11 (95.6 %, 44/46) and ST86 (4.4 %, 2/46). PFGE patterns showed four clusters. Conclusion. The CRKP ST11 clone with co-production of CTX-M-65 and KPC-2 disseminated in ICUs of this tertiary teaching hospital in central China. The emergence of CRKP with a hypermucoviscosity phenotype in ICUs should be of particular concern., UL https://www.microbiologyresearch.org/content/journal/jmm/10.1099/jmm.0.000981