Prevalence and Molecular Typing of Carbapenemase-Producing Enterobacterales among Newborn Patients in Italy.
Marilena AgostaDaniela BencardinoMarta ArgentieriLaura PansaniAnnamaria SistoMarta Luisa Ciofi Degli AttiCarmen D'AmoreLorenza PutignaniPietro BagolanBarbara Daniela IacobelliAndrea DottaLudovica MartiniLuca Di ChiaraMauro MagnaniCarlo Federico PernoFrancesca AndreoniPaola BernaschiPublished in: Antibiotics (Basel, Switzerland) (2022)
The spread of carbapenemase-producing Enterobacterales (CPE), especially Klebsiella pneumoniae ( K. pneumoniae ) and Escherichia coli ( E. coli ), is a serious public health threat in pediatric hospitals. The associated risk in newborns is due to their underdeveloped immune system and limited treatment options. The aim was to estimate the prevalence and circulation of CPE among the neonatal intensive units of a major pediatric hospital in Italy and to investigate their molecular features. A total of 124 CPE were isolated from rectal swabs of 99 newborn patients at Bambino Gesù Children's Hospital between July 2016 and December 2019. All strains were characterized by antimicrobial susceptibility testing, detection of resistance genes, and PCR-based replicon typing (PBRT). One strain for each PBRT profile of K. pneumoniae or E. coli was characterized by multilocus-sequence typing (MLST). Interestingly, the majority of strains were multidrug-resistant and carried the bla NDM gene. A large part was characterized by a multireplicon status, and FII, A/C, FIA (15%) was the predominant. Despite the limited size of collection, MLST analysis revealed a high number of Sequence Types (STs): 14 STs among 28 K. pneumoniae and 8 STs among 11 E. coli , with the prevalence of the well-known clones ST307 and ST131, respectively. This issue indicated that some strains shared the same circulating clone. We identified a novel, so far never described, ST named ST10555, found in one E. coli strain. Our investigation showed a high heterogeneity of CPE circulating among neonatal units, confirming the need to monitor their dissemination in the hospital also through molecular methods.
Keyphrases
- klebsiella pneumoniae
- escherichia coli
- multidrug resistant
- public health
- healthcare
- risk factors
- biofilm formation
- newly diagnosed
- end stage renal disease
- adverse drug
- acute care
- genome wide
- ejection fraction
- single cell
- young adults
- pregnant women
- prognostic factors
- real time pcr
- drug resistant
- genetic diversity
- acinetobacter baumannii
- peritoneal dialysis
- emergency department
- respiratory tract
- gestational age
- gene expression
- dna methylation
- amino acid
- electronic health record
- drug induced
- label free