Section of Bacterial Drug Resistance Research

Carbapenem-resistant Enterobacteriaceae (CRE), including Klebsiella pneumoniae and Escherichia coli, are highly resistant to carbapenems and many other antibiotics. The rapidly increasing prevalence of CRE over the past decade has increased concern in healthcare facilities and public health communities worldwide. Japan is no exception, even though the prevalence of CRE at this time remains low. Our aim is to examine the epidemiological dissemination of CRE in the Southeast Asian countries. Carbapenem resistance is usually carried by plasmid(s) that harbor genes encoding carbapenemases, i.e., class A KPCs, class B metallo-β-lactamases (including IMP, VIM, or NDMs), or class D OXA-type enzymes. We have attempted to isolate CRE from patients admitted to leading hospitals in Thailand and Myanmar. CRE isolates are identified by biochemical characterization or MALDI-TOF-MS, followed by profiling using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). We then determine the whole genome sequence of CRE isolates to identify the full plasmid and construct a comprehensive image of the relationships between isolates based on MLST and phylogeny. By undertaking these genomic epidemiological studies, we increase our understanding of how CRE spread and may be able to identify potential reservoirs.