Byun JH, et al. Ann Lab Med. 2019 Mar;39(2):190-199. https://doi.org/10.3343/alm.2019.39.2.190

Bongyoung Kim, M.D., Ph.D., Jin-Hong Kim, M.D., and Yangsoon Lee, M.D., Ph.D.. Ann Lab Med 2022;42:203-12. https://doi.org/10.3343/alm.2022.42.2.203

The aims of this study were to investigate any change in PCR ribotypes and to determine the antimicrobial resistance of common PCR ribotypes over a 10-year period in a tertiary care hospital. We conducted PCR ribotyping, antimicrobial susceptibility testing and DNA gyrase sequencing to identify changes in 1407 Clostridium difficile non-duplicated isolates obtained between 2000 and 2009. A total of 74 different ribotypes were found. The most prevalent ribotype was ribotype 001 (26.1 %). The prevalence of ribotype 017 was 17 % and that of ribotype 014/020 was 9.6 %. Ribotyping showed that the prevalence of ribotype 001 decreased and the prevalence of ribotypes 017, 014/020 and 018 increased over the 10 years. Antimicrobial resistance rates in prevalent ribotypes were: clindamycin, 81 %; cefotetan, 19 %; moxifloxacin, 42 %; imipenem, 8 %; ciprofloxacin, 100 % and erythromycin, 80 %. Ribotype 018 showed greater antimicrobial resistance than other ribotypes. All ribotype 018 strains showing moxifloxacin resistance had a substitution of a gyrA coding amino acid (Thr82 to Ile). This study will help the understanding of PCR ribotype trends and antimicrobial resistance of C. difficile in Korea.

We analyzed the whole genome sequence and resistome of the outbreakKlebsiella pneumoniaestrain MP14 and compared it with those ofK. pneumoniaecarbapenemase- (KPC-) producing isolates that showed high similarity in the NCBI genome database. A KPC-2-producing multidrug-resistant (MDR)K. pneumoniaeclinical isolate was obtained from a patient admitted to a Korean hospital in 2011. The strain MP14 was resistant to all testedβ-lactams including monobactam, amikacin, levofloxacin, and cotrimoxazole, but susceptible to tigecycline and colistin. Resistome analysis showed the presence ofβ-lactamase genes includingblaKPC-2,blaSHV-11,blaTEM-169, andblaOXA-9. MP14 also possessedaac(6′-)Ib,aadA2,andaph(3′-)Iaas aminoglycoside resistance-encoding genes,mph(A)for macrolides,oqxAandoqxBfor quinolone,catA1for phenicol,sul1for sulfonamide, anddfrA12for trimethoprim. Both SNP tree and cgMLST analysis showed the close relatedness with the KPC producers (KPNIH strains) isolated from an outbreak in the USA and colistin-resistant strains isolated in Italy. The plasmid-scaffold genes in plasmids pKpQil, pKpQil-IT, pKPN3, or pKPN-IT were identified in MP14, KPNIH, and Italian strains. The KPC-2-producing MDRK. pneumoniaeST258 stain isolated in Korea was highly clonally related with MDRK. pneumoniaestrains from the USA and Italy. Global spread of KPC-producingK. pneumoniaeis a worrying phenomenon.

Choi SJ, et al. J Korean Med Sci. 2021 Jun;36(28):e189. https://doi.org/10.3346/jkms.2021.36.e189

Lee Y. Infect Chemother. 2017 Sep;49(3):236-237. https://doi.org/10.3947/ic.2017.49.3.236