Spread of Carbapenem-Resistant Enterobacteriaceae in a Region, China: How to Control?
Abstract Background The increasing number of carbapenem-resistant Enterobacteriaceae (CRE) has become a serious problem globally. This study aimed to elucidate their geographically epidemiological characteristics and explore evidence-based infection control measures. Results A total of 930 phenotypically confirmed CRE isolates collected from 19 hospitals were genotypically characterised. K.pneumoniae (KP) and E.coli isolates were 787 (85.17%) and 96 (10.39%) among 924 carbapenemase-producing Enterobacteriaceae (CPE) isolates. Two major carbapenemase genes KPC-2 and NDM in CPE isolates accounted for 84.63% (n = 782) and 13.74% (n = 127). ST11 comprised 86.32% (631/731) of KPC-2 KP isolates. Wzi typing could discriminate ST11 KP clones and precisely track their transmission. Conjugation assays demonstrated that Some KPC-2- and NDM-bearing plasmids could be conjugatively transferred. The transferability was influenced by different STs and different wzis. CRE patients were becoming increasingly younger due to nosocomial CRE acquisition. The average length of hospitalization of these patients showed a downward trend mainly due to significant increases in voluntarily discharged rates and mortality rates. No associations between the rates of antibiotics consumption and CRE prevalence were observed. Evidence-based measures could effectively reduce the prevalence of ST11-wzi209 clone but failed to control the dissemination of ST11-wzi141 KP clone. Conclusions Continued vigilance for the importations should be maintained. Coordinated regional interventions are urgently needed to reduce CRE threat.