1887

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Volume 65, Issue 8

Emergence and characterization of tigecycline resistance in multidrug-resistant isolates from blood samples of patients in intensive care units in northern China Free

Abstract

Serious infections in intensive care unit patients caused by multidrug-resistant (MDR) represent a major threat worldwide owing to increased mortality and limited treatment options. With the application of tigecycline for MDR pathogens, tigecycline-non-susceptible isolates have recently emerged in China. To identify the susceptibility profile of MDR to tigecycline and evaluate the molecular characterization of tigecycline resistance, 214 MDR isolates were collected from blood samples of patients in intensive care units. MICs and clonal relatedness were determined by standard broth microdilution and multilocus sequence typing, respectively. Expression levels of efflux pumps and their global regulators were examined using real-time PCR. Mutations of local repressor were identified by PCR and sequencing. Our results show that the tigecycline resistance rate of 214 MDR isolates was 6.07 %. ST11 was the predominant clone type of tigecycline-non-susceptible isolates. Expression of efflux pump AcrB and global regulator RamA correlated with tigecycline MICs (AcrB: =8.91, =0.03; RamA: =13.91, <0.01), and mean expression levels of AcrB for the MICs ≥4 mg l were significantly higher than MICs ≤2 mg l (=2.48, =0.029). In addition, one tigecycline-resistant isolate harboured a deletion mutation in the gene. These data indicated a linear correlative trend for overexpression of the AcrB and the tigecycline MICs resulting from the upregulation of RamA. The emergence of molecular type ST11 of MDR isolates should be monitored to identify factors that contribute to tigecycline resistance in intensive care units.

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Keyword(s): blood samples , efflux pump , intensive care unit , Klebsiella pneumoniae , sequence type 11 and tigecycline resistance
© 2016 The Authors
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2016-08-01
2024-04-20
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Emergence and characterization of tigecycline resistance in multidrug-resistant Klebsiella pneumoniae isolates from blood samples of patients in intensive care units in northern China
J. Med. Microbiol. 65, 751 (2016); https://doi.org/10.1099/jmm.0.000299
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