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Systematic review of carbapenem-resistant Enterobacteriaceae causing neonatal sepsis in China.

Ding, Y; Wang, Y; Hsia, Y; Sharland, M; Heath, PT (2019) Systematic review of carbapenem-resistant Enterobacteriaceae causing neonatal sepsis in China. Ann Clin Microbiol Antimicrob, 18 (1). p. 36. ISSN 1476-0711 https://doi.org/10.1186/s12941-019-0334-9
SGUL Authors: Heath, Paul Trafford Sharland, Michael Roy Hsia, Yingfen

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Abstract

BACKGROUND: Carbapenems are β-lactam antibiotics which are used to treat severe infections caused by multidrug resistant Enterobacteriacea. The recent emergence and rapid spread of Enterobacteriaceae resistant to carbapenems is a global concern. We undertook a systematic review of the antibiotic susceptibility and genotypic characteristics of carbapenem-resistant Enterobacteriaceae in Chinese neonates. METHODS: Systematic literature reviews were conducted (PubMed/Medline, Embase, Wanfang medical online databases, China National Knowledge Infrastructure (CNKI) database) regarding sepsis caused by carbapenem-resistant Enterobacteriaceae in Chinese neonates aged 0-30 days. RESULTS: 17 studies were identified. Eleven patients in the six studies reported the source of infection. Ten patients (10/11, 90.9%) were hospital-acquired infections. Genotypic data were available for 21 isolates in 11 studies (20 K. pneumoniae, 1 E. coli). NDM-1 was the most frequently reported carbapenem-resistant genotype (81.0%, 17/21). Carbapenem-resistant Klebsiella pneumoniae and Escherichia coli were resistant to many antibiotic classes with the exception of colistin and fosfomycin. Sequence type 105 (ST105) was the most commonly reported K. pneumoniae ST type (30.8%; 4/13), which was from the same hospital in Western China. ST17 and ST20 were the second and third most common K. pneumoniae ST type, 23.1% (3/13) and 15.4% (2/13) respectively. The three strains of ST17 are all from the same hospital in central China. The two strains of ST20, although not from the same hospital, belong to the eastern part of China. CONCLUSIONS: Klebsiella pneumoniae with the NDM-1 genotype was the leading cause of neonatal carbapenem resistant sepsis in China. Hospital acquired infection is the main source of carbapenem resistant sepsis. There is currently no licenced antibiotic regimen available to treat such an infection in China. Improved surveillance, controlling nosocomial infection and the rational use of antibiotics are the key factors to prevent and reduce its spread.

Item Type: Article
Additional Information: © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Carbapenem-resistant, Escherichia coli, Genotype, Klebsiella pneumoniae, Neonate, 1103 Clinical Sciences, Microbiology
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Ann Clin Microbiol Antimicrob
ISSN: 1476-0711
Language: eng
Dates:
DateEvent
14 November 2019Published
29 October 2019Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
QML 20181207Beijing Hospitals Authority Youth ProgrammeUNSPECIFIED
81872676National Natural Science Foundation of Chinahttp://dx.doi.org/10.13039/501100001809
7192063Beijing Municipality Natural Science FoundationUNSPECIFIED
XTYB201806Special Fund of the Pediatric Medical Coordinated Development Center of Beijing Municipal Administration of HospitalsUNSPECIFIED
PubMed ID: 31727088
Go to PubMed abstract
URI: http://sgultest.da.ulcc.ac.uk/id/eprint/111327
Publisher's version: https://doi.org/10.1186/s12941-019-0334-9

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