Transmission Dynamics of Carbapenem-Resistant Klebsiella pneumoniae Sequence Type 11 Strains Carrying Capsular Loci KL64 and rmpA/rmpA2 Genes.
Transmission Dynamics of Carbapenem-Resistant Klebsiella pneumoniae Sequence Type 11 Strains Carrying Capsular Loci KL64 and rmpA/rmpA2 Genes.
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携带荚膜基因座 KL64 和 rmpA/rmpA2 基因的耐碳青霉烯类肺炎克雷伯菌序列 11 型菌株的传播动力学
DOI：
10.3389/fmicb.2021.736896
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发表时间：
2021
影响因子：
5.2
通讯作者：
Ruan Z
中科院分区：
文献类型：
--
作者：
Kong Y;Sun Q;Chen H;Draz MS;Xie X;Zhang J;Ruan Z
耐碳青霉烯类肺炎克雷伯菌(CRKP)的存在和传播经常在世界范围内引起危及生命的感染，但治疗选择有限。本研究应用全基因组测序技术(WGS)对两起胎儿医院感染暴发疫情中分离到的CRKP菌株的流行病学特征和传播动态进行了分析。2016年4月至2018年3月，从杭州市一家三级医院中国的无菌标本中共采集到70株肺炎克雷伯菌。采用肉汤微量稀释法测定21种抗菌药的最低抑菌浓度(MIC)。对47株CRKP菌株进行了脉冲场凝胶电泳(PFGE)，对16株克隆性相关菌株进行了Illumina测序。此外，还利用牛津纳米孔测序技术测定了三个代表菌株(KP12、KP36和KP37)的全基因组序列。肺炎克雷伯菌分离株是从被诊断为肺部感染、癌症或脑病的患者中恢复的。对于所有CRKP分离株，PFGE在所有菌株中分离出三个聚类群。最主要的PFGE聚集群包含16个从共享医院病房的患者中收集的代表潜在暴发的分离物。所有16株菌株对18种抗菌药物均表现出极高的耐药性(≥为87.5%)，但对粘菌素仍敏感。在16株CRKP中发现了多重耐药性和毒力决定因素，如碳青霉烯类耐药基因bla kpc-2，毒力因子需氧蛋白和粘液表型调节基因(rmpA和rmpA2)。这些分离株属于序列类型11(ST11)和衣壳血清型KL64。基于核心基因组单核苷酸多态性(CgSNP)的系统发育分析表明，16株CRKP分离株可被划分为两个独立的分支(≤15个SNP)，这表明两种独立的传播情景共同发生。此外，在ST11-KL64 CRKP分离株中同时含有iroBCDN基因缺失的IncFIB/IncHI1B型毒力质粒和携带IncFII/INCR型BLAKPC-2基因的质粒。综上所述，我们的数据表明，ST11-KL64 CRKP克隆在医院的传播对抗感染治疗是一个潜在的威胁。迫切需要开发监测、诊断和治疗这种高风险CRKP克隆的新策略。
The presence and dissemination of carbapenem-resistant Klebsiella pneumoniae (CRKP) often cause life-threatening infections worldwide, but the therapeutic option is limited. In this study, whole-genome sequencing (WGS) was applied to assess the epidemiological characteristics and transmission dynamics of CRKP isolates recovered from two fetal outbreaks of nosocomial infections. Between April 2016 and March 2018, a total of 70 isolates of K. pneumoniae were collected from sterile samples in a tertiary hospital in Hangzhou, China. The minimal inhibitory concentrations (MICs) of 21 antimicrobial agents were determined using the broth microdilution methods. Pulsed-field gel electrophoresis (PFGE) was performed on 47 CRKP isolates, and 16 clonally related isolates were further characterized by Illumina sequencing. In addition, the complete genome sequences of three representative isolates (KP12, KP36, and KP37) were determined by Oxford Nanopore sequencing. The K. pneumoniae isolates were recovered from patients diagnosed with pulmonary infection, cancer, or encephalopathy. For all CRKP isolates, PFGE separated three clusters among all strains. The most predominant PFGE cluster contained 16 isolates collected from patients who shared close hospital units and represented a potential outbreak. All 16 isolates showed an extremely high resistance level (≥87.5%) to 18 antimicrobials tested but remain susceptible to colistin (CST). Multiple antimicrobial resistance and virulence determinants, such as the carbapenem resistance gene bla KPC-2, and genes encoding the virulence factor aerobactin and the regulator of the mucoid phenotype (rmpA and rmpA2), were observed in the 16 CRKP isolates. These isolates belonged to sequence type 11 (ST11) and capsular serotype KL64. A core genome single nucleotide polymorphism (cgSNP)-based phylogenetic analysis indicated that the 16 CRKP isolates could be partitioned into two separate clades (≤15 SNPs), suggesting the two independent transmission scenarios co-occurred. Moreover, a high prevalence of IncFIB/IncHI1B type virulence plasmid with the iroBCDN locus deleted, and an IncFII/IncR type bla KPC-2-bearing plasmid was co-harbored in ST11-KL64 CRKP isolates. In conclusion, our data indicated that the nosocomial dissemination of ST11-KL64 CRKP clone is a potential threat to anti-infective therapy. The development of novel strategies for surveillance, diagnosis, and treatment of this high-risk CRKP clone is urgently needed.
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影响因子：
14.9
作者：
Letunic I;Bork P
通讯作者：
Bork P
影响因子：
28.2
作者：
Spencer, Melanie D.;Winglee, Kathryn;Fodor, Anthony A.
通讯作者：
Fodor, Anthony A.
影响因子：
3.9
作者：
de Campos, Tatiana Amabile;Goncalves, Laura Fernandes;Pitondo-Silva, Andre
通讯作者：
Pitondo-Silva, Andre
影响因子：
9.4
作者：
TENOVER, FC;ARBEIT, RD;SWAMINATHAN, B
通讯作者：
SWAMINATHAN, B
使用 Nanopore 和 Illumina 测序对全耐药肺炎克雷伯菌菌株进行混合基因组组装和注释
影响因子：
3.9
作者：
Ruan, Zhi;Wu, Jianyong;He, Fang
通讯作者：
He, Fang