First description of NDM-1-, KPC-2-, VIM-2-and IMP-4-producing Klebsiella pneumoniae strains in a single Chinese teaching hospital
First description of NDM-1-, KPC-2-, VIM-2-and IMP-4-producing Klebsiella pneumoniae strains in a single Chinese teaching hospital
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DOI：
10.1017/s0950268814000995
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发表时间：
2015-01-01
影响因子：
4.2
通讯作者：
Xu, Q. -F.
中科院分区：
文献类型：
--
作者：
Liu, Y.;Wan, L. -G.;Xu, Q. -F.
从2010年12月至2012年1月在中国某医院住院的患者中共分离出180株非重复的耐碳青霉烯肺炎克雷伯菌。鉴定出8个KPC-2、4个NDM-1、1个VIM-2和5个KPC-2 + IMP-4产生体，由于存在其他耐药决定因素，包括广谱β -内酰胺酶（CTX-M-15、SHV-12）、16S rRNA甲基化酶（armA、rmtB）和质粒介导的喹诺酮类药物耐药决定因素（qnrA、B、S、aac（6’）-Ib-cr），它们都具有多重耐药性。鉴定出9个肺炎克雷伯菌克隆（Kpn-A1/ST395、Kpn-A3/ST11、Kpn-A2/ST134、Kpn-B/ST263、Kpn-C/ST37、Kpn-D/ST39、Kpn-E/ST1151、Kpn-F/ST890、Kpn-G/ST1153）。bla（KPC-2）分别位于类似65 kb的IncL/M （ST395、ST11、ST134、ST39）和类似100 kb的IncA/C （ST37、ST1153、ST890）质粒上。另一方面，bla（NDM-1）与一个类似70kb的IncA/C质粒（ST263）相关。然而，在ST1151克隆中检测到含有bla（VIM-2）的约40 kb的不可分型质粒。本文报道了中国首次在一家医院同时发现四种不同类型的肺炎克雷伯菌克隆碳青霉烯酶。IncA/C， IncL/M和其他成功的质粒可能对碳青霉烯酶的传播很重要，从而产生复杂的流行病学图像。
A total of 180 non-duplicate carbapenem-resistant Klebsiella pneumoniae isolates were recovered from patients hospitalized between December 2010 and January 2012 at a Chinese hospital. Eight KPC-2, four NDM-1, one VIM-2, and five KPC-2 plus IMP-4 producers were identified and all were multidrug resistant due to the presence of other resistance determinants, including extended-spectrum beta-lactamases (CTX-M-15, SHV-12), 16S rRNA methylases (armA, rmtB) and plasmid-mediated quinolone-resistance determinants (qnrA, B, S, aac(6')-Ib-cr). Nine K. pneumoniae clones (Kpn-A1/ST395, Kpn-A3/ST11, Kpn-A2/ST134, Kpn-B/ST263, Kpn-C/ST37, Kpn-D/ST39, Kpn-E/ST1151, Kpn-F/ST890, Kpn-G/ST1153) were identified. bla(KPC-2) was located on transferable similar to 65 kb IncL/M (ST395, ST11, ST134, ST39) and similar to 100 kb IncA/C (ST37, ST1153, ST890) plasmids, respectively. On the other hand, bla(NDM-1) was associated with a similar to 70 kb IncA/C plasmid (ST263). However, non-typable plasmids of similar to 40 kb containing bla(VIM-2) were detected in the ST1151 clone. This work reports the first co-occurrence of four diverse types of carbapenemase of K. pneumoniae clones from a single hospital in China. IncA/C, IncL/M, and other successful plasmids may be important for the dissemination of carbapenemases, producing a complex epidemiological picture.