Emergence of KPC-3- and OXA-181-producing ST13 and ST17 Klebsiella pneumoniae in Portugal: genomic insights on national and international dissemination.
Emergence of KPC-3- and OXA-181-producing ST13 and ST17 Klebsiella pneumoniae in Portugal: genomic insights on national and international dissemination.
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葡萄牙出现产 KPC-3 和 OXA-181 的 ST13 和 ST17 肺炎克雷伯菌：对国内和国际传播的基因组见解。
DOI：
10.1093/jac/dkad093
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Elias R
中科院分区：
文献类型：
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作者：
Elias R
背景碳青霉烯类抗生素耐药肺炎克雷伯菌（CRKP）菌株尤其值得关注，尤其是具有可移动碳青霉烯酶基因如blaKPC、blaNDM或blaOXA-48的菌株，因为碳青霉烯类抗生素通常是β-内酰胺类的最后一线药物，对该亚类的抗性与死亡率增加相关，并且经常共同发生耐药的其他抗菌类。目的描述基因组多样性和国际传播的CRKP菌株从三级保健医院，方法对20株从不同患者中分离的CRKP菌株进行WGS分型、种属确认、耐药基因检测和系统发育重建。两个额外的基因组数据集包括比较的目的：26个分离株（ST 13，ST 17和ST 231）从我们的收集和64个国际上可用的基因组组件（ST 13）。结果通过施加一个21 SNP的截断成对比较，我们确定了两个基因组簇（GC）：ST 13/GC 1（n= 11），所有轴承blaKPC-3，和ST 17/GC 2（n= 4）harbouringblaOXA-181和blaCTX-M-15基因。 纳入额外的数据集后，GC 1/ST 13/KPC-3的分离株扩展至23株，全部仅来自葡萄牙、法国和荷兰。系统发育树加强了GC 1/KPC-3生产克隆的重要性，沿着它们在这些国家的迅速出现和扩张。所获得的数据表明，ST 13分支出现在十多年前，只是最近才巩固了一个更强的脉冲在研究population.ConclusionsThis研究确定了一个新兴的OXA-181/ST 17生产菌株在葡萄牙，并强调了正在进行的国际传播的KPC-3/ST 13生产克隆从葡萄牙。
BackgroundCarbapenem-resistantKlebsiella pneumoniae(CRKP) strains are of particular concern, especially strains with mobilizable carbapenemase genes such asblaKPC,blaNDMorblaOXA-48, given that carbapenems are usually the last line drugs in the β-lactam class and, resistance to this sub-class is associated with increased mortality and frequently co-occurs with resistance to other antimicrobial classes.ObjectivesTo characterize the genomic diversity and international dissemination of CRKP strains from tertiary care hospitals in Lisbon, Portugal.MethodsTwenty CRKP isolates obtained from different patients were subjected to WGS for species confirmation, typing, drug resistance gene detection and phylogenetic reconstruction. Two additional genomic datasets were included for comparative purposes: 26 isolates (ST13, ST17 and ST231) from our collection and 64 internationally available genomic assemblies (ST13).ResultsBy imposing a 21 SNP cut-off on pairwise comparisons we identified two genomic clusters (GCs): ST13/GC1 (n= 11), all bearingblaKPC-3, and ST17/GC2 (n= 4) harbouringblaOXA-181andblaCTX-M-15genes. The inclusion of the additional datasets allowed the expansion of GC1/ST13/KPC-3 to 23 isolates, all exclusively from Portugal, France and the Netherlands. The phylogenetic tree reinforced the importance of the GC1/KPC-3-producing clones along with their rapid emergence and expansion across these countries. The data obtained suggest that the ST13 branch emerged over a decade ago and only more recently did it underpin a stronger pulse of transmission in the studied population.ConclusionsThis study identifies an emerging OXA-181/ST17-producing strain in Portugal and highlights the ongoing international dissemination of a KPC-3/ST13-producing clone from Portugal.