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Abstract

Carbapenemase-producing Enterobacteriaceae (CPE) have emerged as a global threat to public health and clinical practice.

In Thailand, reports describing CPEs carrying and -like genes have been increasing recently; however, data on detailed plasmid analysis and temporal shift of sequence type and carbapenemase type are limited.

In this study, we analysed whole-genome sequencing (WGS) data of clinically isolated carbapenemase-producing (CPKP) to reveal the molecular epidemiology of CPKP in a tertiary-care hospital in Bangkok, Thailand.

Seventy-seven non-duplicated CPKP isolates collected during 2013–2016 were examined for their drug-resistance genes, sequence types and phylogenetic relationships.

All the tested isolates possessed carbapenemase gene(s), and the major type of carbapenemase gene in 2014–2015 was , whereas isolates in 2016 harboured more than . Other carbapenemase gene variants, such as , , , and were detected in some CPKP isolates. Furthermore, this study revealed that CPKP co-harbouring two genes, and or , emerged during this period. Notably, such isolates co-carrying the two carbapenemase genes emerged in three different sequence types, even in a single hospital, and then spread clonally. The WGS of CPKP revealed a temporal shift of the predominant carbapenemase genes from to along with a variation in other carbapenemase gene types within a span of 4 years.

Our findings suggest that a substantial change in CPE types occurred in Thailand and potentially in Southeast Asian countries.

Funding
This study was supported by the:
  • Japan Agency for Medical Research and Development (Award 21wm0125010h0001)
    • Principle Award Recipient: YukihiroAkeda
  • Japan Agency for Medical Research and Development (Award 21wm0225013h0502)
    • Principle Award Recipient: TetsuyaIida
  • Japan Agency for Medical Research and Development (Award JP18fm0108003)
    • Principle Award Recipient: ShigeyukiHamada
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2023-06-09
2024-10-08
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