Institutional outbreak involving multiple clades of IMP-producing Enterobacter cloacae complex sequence type 78 at a cancer center in Tokyo, Japan.
Institutional outbreak involving multiple clades of IMP-producing Enterobacter cloacae complex sequence type 78 at a cancer center in Tokyo, Japan.
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DOI：
10.1186/s12879-021-05952-9
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发表时间：
2021-03-22
影响因子：
3.7
通讯作者：
Hayama B
中科院分区：
文献类型：
--
作者：
Harada S;Aoki K;Ohkushi D;Okamoto K;Takehana K;Akatsuchi T;Ida K;Shoji D;Ishii Y;Doi Y;Moriya K;Hayama B
关于产IMP肠球菌的临床和微生物学特征的信息有限。在这里，我们描述了一个机构爆发的IMP生产肠杆菌复杂（ECC）涉及多个分支的ECC序列型（ST）78菌株。对4年研究期间分离的18株产IMP ECC菌株进行了药敏试验、全基因组测序和接合试验。通过平均核苷酸同源性分析确定种和亚种，并通过多位点序列分型和核心基因组单核苷酸多态性（SNP）分析来分析分离物的克隆相关性。从病历中提取相关临床信息。18株产IMP ECC分离株中有14株被确定为霍氏肠杆菌ST 78。16个分离株，包括13个属于ST 78的分离株，携带blaIMP-1的In 316样1类整合子，也携带IncHI 2质粒。12株携带blaIMP-1的IncHI 2质粒分离株和1株携带blaIMP-11的IncL/M质粒分离株的偶联实验均获得成功。虽然ST 78菌株的分离在14个月的时间内聚集，表明医院传播，这些菌株通过SNP分析被细分为三个分支：分支A（n = 10），分支B（n = 1），分支C（n = 3）。根据分离菌株时的流行病学信息，部分克隆相关性是意料之外的。大多数产IMP的ECC菌株对非β-内酰胺类抗生素敏感，对碳青霉烯类的最低抑菌浓度相对较低（≤4 μg/mL）。由产生IMP的ECC引起的六例感染中有五例得到成功治疗。全基因组测序分析显示，暴发是由三种不同的ST 78菌株分支引起的，与产生其他碳青霉烯酶的肠球菌引起的感染相比，患者对感染的治疗结果有利，这可能是由于其非多药耐药表型。在线版本包含补充材料，可通过10.1186/s12879-021-05952-9获得。
Information about the clinical and microbiological characteristics of IMP-producing Enterobacterales has been limited. Here, we describe an institutional outbreak of IMP-producing Enterobacter cloacae complex (ECC) involving multiple clades of ECC sequence type (ST) 78 strains. Antimicrobial susceptibility testing, whole-genome sequencing, and conjugation experiments of 18 IMP-producing ECC strains isolated during four-year study period were performed. Species and subspecies were determined by average nucleotide identity analysis and clonal relatedness of the isolates was analyzed with multilocus sequence typing and core-genome single nucleotide polymorphism (SNP) analysis. Relevant clinical information was extracted from medical records. Fourteen of 18 IMP-producing ECC isolates were determined as Enterobacter hormaechei ST78. Sixteen isolates, including 13 isolates belonging to ST78, carried blaIMP-1 in In316-like class 1 integron and also carried IncHI2 plasmids. Conjugation experiments were successful for 12 isolates carrying blaIMP-1 on IncHI2 plasmids and for an isolate carrying blaIMP-11 on an IncL/M plasmid. Although isolation of ST78 strains was clustered in a 14-months period suggesting nosocomial transmission, these strains were subdivided into three clades by SNP analysis: clade A (n = 10), clade B (n = 1), clade C (n = 3). A part of clonal relatedness was unexpected by the epidemiological information at the time of isolation of the strains. Most of the IMP-producing ECC strains were susceptible to non-β-lactam antibiotics and had relatively low minimum inhibitory concentrations to carbapenems (≤4 μg/mL). Five of six infections caused by IMP-producing ECC were treated successfully. Whole-genome sequencing analysis revealed the outbreak was caused by three different clades of ST78 strains, where patients had favorable treatment outcome of the infections compared with that caused by Enterobacterales producing other carbapenemases, possibly due to their non-multidrug-resistant phenotype. The online version contains supplementary material available at 10.1186/s12879-021-05952-9.
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影响因子：
6.9
作者：
Yamamoto, N.;Asada, R.;Tomono, K.
通讯作者：
Tomono, K.
碳青霉酶产生肠杆菌属的全面基因组分析：对系统发育，种群结构和耐药机制的新见解。
影响因子：
6.4
作者：
Chavda KD;Chen L;Fouts DE;Sutton G;Brinkac L;Jenkins SG;Bonomo RA;Adams MD;Kreiswirth BN
通讯作者：
Kreiswirth BN
影响因子：
4.9
作者：
Wang, Xiaojuan;Wang, Qi;Wang, Hui
通讯作者：
Wang, Hui
影响因子：
4.9
作者：
Kanamori, Hajime;Parobek, Christian M.;Rutala, William A.
通讯作者：
Rutala, William A.
影响因子：
9.4
作者：
Wilkinson, Kathryn M.;Winstanley, Trevor G.;Perry, John D.
通讯作者：
Perry, John D.