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Background  Carbapenemase-producing  Klebsiella pneumoniae  (CPKP)  strains  have emerged as a major problem for healthcare systems. The aim of this study was to determine the circulating clones and analyze the clinical and molecular characteristics of CPKP in our hospital.    Methods  A total of 74 carbapenemase producers collected from our hospital from 2012 to 2014 were analyzed for the prevalence of extended-spectrum β-lactamase (ESBLs), plasmid-mediated quinolone resistance genes (PMQRs), exogenously acquired 16S rRNA methyltransferase (16S-RMTase), and plasmid-mediated AmpC enzyme (pAmpCs) by PCR and DNA sequencing. The sequence types (STs) of the carbapenemase producers were analyzed by multi-locus sequence typing (MLST). And Pulsed-field gel electrophoresis (PFGE) was performed to investigate the genetic relationship of KPC-2 producing strains. Clinical data were retrieved from the medical records.    Results  KPC-2 (n = 72) was the predominant enzyme followed by NDM-1 (n = 2); The genes  bla CTX-M,  bla SHV,  bla TEM-1,  bla DHA-1,  rmtB ,  armA ,  oqxA ,  oqxB , and  qnrB  were present in 29 (39.2 %), 27 (36.5 %), 46 (62.2 %), 2 (2.7 %), 25 (33.8 %), 1 (1.4 %), 60 (81.1 %) and 56 (75.7 %), 6 (8.1 %) isolates, respectively. MLST analysis revealed 10 different STs. The most dominant ST was ST11 (78.4 %, 58/74), followed by ST15 (8.1 %, 6/74). PFGE patterns of the KPC-2 producing  K. pneumoniae  isolates exhibited clonal dissemination of ST11 and ST15 clones as well as a genetic diversity of the remaining strains.    Conclusion  The intra- and inter-hospital cross-transmission of KPC-2-producing  K .  pneumoniae  ST11 co-carrying  oqxAB  and  rmtB  in our hospital strongly suggested that rapid identification of colonized or infected patients and screening of carriers is quite necessary to prevent a scenario of endemicity.

annals of clinical microbiology and antimicrobials

Clonal dissemination of KPC-2 producing Klebsiella pneumoniae ST11 clone with high prevalence of oqxAB and rmtB in a tertiary hospital in China: results from a 3-year period