Aim: We investigated the clonal diversity of carbapenemase-producing Klebsiella pneumoniae  isolates from the Shenzhen Children’s Hospital, China, and drew conclusions on the clinical and public health impact of these isolates as multidrug-resistant.
Methods: From January 2014 to December 2018, a total number of 36 unique carbapenemase-producing clinical isolates of Klebsiella pneumoniae  were collected out of 900 clinical isolates in paediatric patients from the Shenzhen Children’s Hospital, China. After carbapenemase production confirmation, antimicrobial susceptibility, resistance determinants and phylogenetic relationship were determined.
Results: The isolates showed resistance to ceftazidime, ertapenem, ampicillin, cefazolin, ceftriaxone, cefotetan, ticarcillin, cefaclor, cefpodoxime, azlocillin, cefcapene, mezlocillin and ampicillin-sulbactam. Of the 36 Klebsiella pneumoniae  carbapenemase genes coding isolates, bla _NDM was the mostly detected 50% (n=18) followed by bla _KPC and bla _IMP 19% (n=7), bla _VIM 17% (n=6), bla _OXA-48-like 8% (n=3) and bla _SME 5% (n=2), whereas extended-spectrum β-lactamase (bla _SHV) was predominantly detected 92% (n=33) followed by bla _CTX-M 53% (n=19) and bla _CMY 28% (n=10). Pulsed-field gel electrophoresis typing showed eight different patterns, and twenty-five distinct sequences types were observed with ST307 being predominantly identified 11% (n=4), followed by ST2407 8% (n=3). Plasmid replicon typing results indicated that IncFIS, IncHI2, IncFIC and IncFIA plasmids carry bla _CTX-M, bla _SHV and bla _NDM genes.
Conclusion: This study reports on the occurrence and spread of carbapenemase and extended-spectrum β-lactamase encoding genes co-existence in sporadic Klebsiella pneumoniae  ST307 in paediatric patients from the Shenzhen Children’s Hospital, China.
Keywords: Klebsiella pneumoniae , carbapenemase, ESBLs, antimicrobial susceptibility, molecular characterization