Emergence of ST307 Co-Producing CTX-M with SHV and KPC from Paediatric Patients at Shenzhen Children's Hospital, China.

Aim: We investigated the clonal diversity of carbapenemase-producing 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 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 carbapenemase genes coding isolates, was the mostly detected 50% (n=18) followed by and 19% (n=7), 17% (n=6), 8% (n=3) and 5% (n=2), whereas extended-spectrum β-lactamase ( ) was predominantly detected 92% (n=33) followed by 53% (n=19) and 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 and genes.

Conclusion: This study reports on the occurrence and spread of carbapenemase and extended-spectrum β-lactamase encoding genes co-existence in sporadic ST307 in paediatric patients from the Shenzhen Children's Hospital, China.