Acquisition of Plasmid with Carbapenem-Resistance Gene blaKPC2 in Hypervirulent Klebsiella pneumoniae, Singapore
Acquisition of Plasmid with Carbapenem-Resistance Gene blaKPC2 in Hypervirulent Klebsiella pneumoniae, Singapore
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DOI：
10.3201/eid2603.191230
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发表时间：
2020-03-01
影响因子：
11.8
通讯作者：
Gan, Yunn-Hwen
中科院分区：
文献类型：
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作者：
Chen, Yahua;Marimuthu, Kalisvar;Gan, Yunn-Hwen
肺炎克雷伯菌碳青霉烯抗性和高毒力基因的趋同导致了能够引起侵袭性疾病的高度耐药超级细菌的出现。我们分析了2010-2015年从新加坡医院患者中分离出的556株耐碳青霉烯类肺炎克雷伯菌，发现来自7例患者的18株分离株也具有高毒力特征。所有分离株均含有一个密切相关的质粒（pKPC2），内含bla(KPC-2)，一种肺炎克雷伯菌碳青霉烯酶基因，具有荚膜血清型K1、K2和K20的高毒力背景。总共，7个首次患者分离株中有5个具有高黏性，6个在小鼠中具有毒性。pKPC2具有高度传染性，并且非常稳定，在没有抗菌药物选择压力的情况下，在患者体内的细菌中维持数月，几乎没有变化。病人体内的分离株在人体内也能获得额外的抗微生物药物耐药基因。我们的研究结果强调了耐碳青霉烯高毒力肺炎克雷伯菌在新加坡的潜在传播。
The convergence of carbapenem-resistance and hypervirulence genes in Klebsiella pneumoniae has led to the emergence of highly drug-resistant superbugs capable of causing invasive disease. We analyzed 556 carbapenem-resistant K. pneumoniae isolates from patients in Singapore hospitals during 2010-2015 and discovered 18 isolates from 7 patients also harbored hypervirulence features. All isolates contained a closely related plasmid (pKPC2) harboring bla(KPC-2), a K. pneumoniae carbapenemase gene, and had a hypervirulent background of capsular serotypes K1, K2, and K20. In total, 5 of 7 first patient isolates were hypermucoviscous, and 6 were virulent in mice. The pKPC2 was highly transmissible and remarkably stable, maintained in bacteria within a patient with few changes for months in the absence of antimicrobial drug selection pressure. Intrapatient isolates were also able to acquire additional antimicrobial drug resistance genes when inside human bodies. Our results highlight the potential spread of carbapenem-resistant hypervirulent K. pneumoniae in Singapore.