Carbapenem-resistant Enterobacterales (CRE) is a global concern. This study investigated the prevalence of fecal colonization carriage and clonal dissemination of CRE among population in four provinces of China. Stool samples were collected from four provinces in China. The overall fecal carriage rate was 9.6% (66/685). The highest prevalence was in Henan province (18.35%, 95% CI: 9%-18.7%). Sixty-six CRE isolates were identified in Escherichia coli (56.06%, 37/66), Klebsiella (15.15%, 10/66), Citrobacter (13.63%, 9/66), Enterobacter (12.12%, 8/66), and Atlantibacter (1.51%, 1/66). Each CRE strain harbored carbapenemase genes and multiple antibiotics resistance genes. blaNDM-5 (77.27%, 51/66) was the most common, followed by blaNDM-1 (19.69%, 13/66). All CRE isolates belonged to different sequence types (STs). ST206 (14/38) E. coli and ST2270 (6/10) Klebsiella were significantly dominant clones. The results indicated the rising prevalence of CRE fecal carriage among healthy adults of China, mostly blaNDM-producing E coli. Screening for CRE colonization is necessary to control infection.
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